Getting Treatment in Winston-Salem, North Carolina
Winston-Salem is full of art and history and has many different museums to show for it. Technology innovation is ever growing in the city as well. Alternatively, just like with any bigger city, Winston-Salem has its fair share of issues too. The issue is poor housing and poor mental health which is causing an even bigger issue, drug addiction. The city has an unemployment rate of 4.1 percent and median income level of $40,480 which doesn’t help the city’s population who is homeless, which also tends to lead to drug use. The city’s crime rate is another factor in drug use as Winston-Salem scores a 6 out of 100, 100 being the safest.
Drugs like heroin and opioids are more widespread but street drugs like cocaine, crack, ecstasy, etc., are much easier to find on the streets. Opioids and heroin account for more fatal overdoses than other drugs. From 1999-2016, opioid fatal overdoses grew by 900 percent. In 2016, more than 675 million painkillers were dispensed to North Carolina, up by 52 percent in a five-year time frame. Doctors have also been arrested for prescribing painkillers to patients who do not need them, medically.
More companies within Forsyth County are expressing interest in creating educational courses to help people who suffer from pain to take advantage of physical therapy, massage techniques and yoga as a way to manage their pain and mood. So many people become addicted to pain killers after suffering some form of accident. Other people choose to sell their own pain pills to make money, which causes someone else to become addicted. Drugs lead to a domino effect in major cities and it’s not just the homeless that are affected. In many cases, high-powered lawyers, doctors, nurses, teachers, etc., are addicted to drugs. In which case, teenagers who are led by example, start using drugs as well.
In any case of drug addiction, help should be obtained but in the case of so many teens dying of drug overdoses, our country is at a time when help is needed tremendously. Teen overdoses climbed by 19 percent from 2014-2015 and more teens are becoming addicted to pain pills and heroin, daily. The best option to get help is through a drug rehabilitation center.
Thinking about drug rehab can offer some pretty negative and scary thoughts to enter one’s mind. It has been proven that the more a person knows the less scary that something is. With that in mind, looking at rehab as a step-by-step process may help calm some anxiety and fears.
Getting into Alcohol and Drug Treatment
Step #1- Assessment/Intake
After one has chosen to enter rehab, the first step involves going through an assessment period. This is usually just a small questionnaire that helps the staff at the facility to know what sort help is needed. There are many different factors that can change the process of healing. What might work for someone else isn’t exactly what will work for another person. The assessment will allow for those initial important questions to be answered.
As with many forms, name and date of birth are pretty standard questions.
Here are a few more:
- Has the patient even been to drug or alcohol rehabilitation before?
- What type of drugs are being used?
- When did patient last use drugs?
- Is there history of drug use?
- Have there been any mental health issues?
With each rehab center, questions will vary though an assessment is generally the kick-off point to learn the very basics. An assessment allows for a doctor and a psychiatrist to learn what sort of treatment should be offered and if treatment if available within the facility. Most rehab centers are fully equipped with helping patients with drug addiction treatment. In some cases, a patient will be recommended to another facility.
After the assessment period, an intake will be taken. Some facilities roll the assessment and intake up into one swift process. The intake is much like an assessment because it has its own questionnaire. It’s important to be as honest as possible while answering questions. Dishonesty can lead to misdiagnosis which isn’t helpful for the doctors or for the patient who increases their chance of relapse.
Intake questions are more detailed:
Family medical and mental health history
Has there been a history of drug or alcohol use in the family?
This process may feel more like an interview process as if one were trying to get a job. Once the questionnaire has been completed, a brief physical exam will be done as well as some lab tests. Lab tests completed are generally a urine test to check for drugs in the system. Even if a patient has stated the last time drugs were used, this test must still be administered.
During this point in the intake period, financial arrangements will be addressed and admittance to the facility will take place. Admittance comes with a list of items that cannot be brought into the facility. The list of items are standard across the board when it comes to drug rehabilitation centers.
- No food/drinks
- No drugs/alcohol
- No weapons
- No revealing clothing
- No pornography
- No mouthwash
- No over-the-counter medication/herbs
- No pillows or bed lines
- No radios or cell phones
Some rehab centers do allow for different items that others do not allow for. This list is very standardized and the one obtained from the admittance period of the intake will have a better idea of what items are permitted and which ones are not.
Step # 2- Detoxification
Now that a patient has been admitted into the facility, has made payment arrangements and has had an item check on their personal items, the patient is ready for detoxification. This step isn’t necessary for all patients. In fact, some patients are free of drugs upon entering rehab and have the ability to go straight to inpatient or outpatient treatment. Alternatively, if the patient’s lab tests show drugs in the system, detox is the next step.
Anxiety and fear is usually wrapped around detox when a person thinks about rehab because in all honestly, it can be a grueling experience. Detox means that the system needs to be completely cleansed of drugs, which means the last drug fix a person ingested is their very last. Depending on the drugs, the withdrawal a patient feels can be very hard to endure. Heroin is a drug that many patients have had a hard time detoxing from. Patients have described the experience as being one of the hardest things that they have ever had to go through. Drugs cause a person to feel good emotionally, mentally and physically so of course, the body and mind crave those feel good feelings even if the process in getting them, is not good. Being addicted to drugs is no different than being addicted to food, to sex, to alcohol, to gambling or anything else. Addiction works the same in any case, the mind and body want it and the mind is very powerful. The mind at this point in the rehabilitation process becomes the patient’s own worst enemy.
That is why so many different withdrawal symptoms occur:
- Muscle pain/tension
- Blurred vision
- Drug cravings
- Runny nose
These symptoms can get so bad that doctors prescribe a medication such as Methadone. Methadone is used in many drug rehabilitation centers to decrease drug cravings and help with nausea.
Other drugs used in rehab centers to calm cravings:
- alleviates withdrawal symptoms
- decreases cravings
- has a ceiling effect, which means that medication effects to level before an overdose can occur
- helps to prevent relapse
- has an extended-release injection that lasts for one month, doesn’t cause withdrawal symptoms with end of use.
- helps to normalize brain activity
- decreases the desire for alcohol
- is not dependent-based.
Withdrawal symptoms can last a few days or weeks but since every patient is different, there is no real standard timeline. The intensity of the symptoms can change from patient to patient as well. There are a number of factors that can make a patient’s withdrawal symptoms worse such as the type of drugs taken, how long drugs have been taken, if alcohol has been taken with the drugs and any mental health problems. Depending on the answers that are given for these questions, withdrawal can be easy going to extremely brutal.
Detox is done through a cold-turkey process as mentioned above so the last bit of drugs a patient has before they enter rehab will be their last. Quitting anything cold-turkey is extremely difficult but there will always be a doctor or nurse present when someone is going through it. Doctors and nurses will check for vital signs and make sure the patient is right on track. In some rare cases, withdrawal symptoms have led to heart attacks in patients.
Step #3- Inpatient and Outpatient Treatment
After detox comes the longest part of the entire rehabilitation process, the treatment. Treatment usually involves a couple of different types pf therapies but again, the doctor assesses a patient and decides what they do or do not need. In some cases, a patient does not need detox or can do an outpatient detox and some patients can go straight to outpatient therapy without having to go to inpatient first. All of this will depend on a patient’s drug and mental history.
Inpatient treatment is generally recommended before any other treatment. Residential Treatment Center (RTC) is an inpatient care that stabilizes a patient within the center for an average of 28 days. Sometimes this day count can go up or down, this decision comes from the doctor or therapist. Some patients stay up to 90 days. RTC incorporates a series of different therapies to help a patient to find out why they turned to drugs in the first place. Generally, there is one moment in a person’s life when drugs became the answer to a deep-rooted issue. Sometimes, genetics play a huge role in drug addiction. Either way, a psychiatrist and therapist will walk the patient through some therapy methods to find out. Group therapy will also be a way for patients to see that others are going through the same thing they are, build companionship and talk to others. Many times, patients meet other patients in rehab and build a life-long friendship.
RTC gives patients structure that is needed. Patients are given a schedule of events and it becomes their responsibility to show-up for their own recovery. This schedule is stocked full of great therapeutic activities such as yoga, painting, different types of therapy, etc. Each rehab is different and will allow different types of therapeutic activities for different patients. Many times, as a patient gets better through time at the center, they can go on outings with family members to eat at a restaurant or to go to the store. Again, this does depend on the facility and some may not allow this as an option.
During RTC, patients will also learn about trigger points. Trigger points are points in time that trigger a reaction from the patient. Most often with people who are addicted to drugs, a trigger point causes a person to crave drugs. For some patients, trigger points can be a past unresolved issue. Learning about trigger points is a great way for patients to continue to help themselves even after rehab.
When a patient has been released from RTC, they are recommended for Partial Hospitalization Programs (PHP). PHP takes place in the facility but only for a period of 6 hours a day, 5-7 days a week. A patient will have some one-on-one therapy while also participating in group therapy. Coping skills to deal with trigger points become a focal point during PHP. Coping skills are used to help patients find something to do that helps to keep the mind off of drugs.
- Restoring old cars
- Art/drawing or painting
- Getting healthy
- Going out with positive friends
Coping skills can be anything that is healthy and keeps the mind off of doing drugs. So, it’s important to think about a passion in life and fulfill it. Anything that helps the mind to cope with the loss of drugs is something that should be kept as a skill to use. Anything that stresses the mind and body out in a very negative way is not a coping skill, it’s a stressor which can activate those trigger points that desire drugs.
PHP will help to keep a patient going on the positive track after RTC.
Next is, IOP (Intensive Outpatient Programs) which is used as the last bit of therapy to help patients in a stair step process of recovery. IOP takes place either at the same facility or most often, at a different facility for 3 hours a day, 3 days a week. Group therapy is the focal point of IOP which allows patients to use social skills taught in RTC and PHP to talk with other patients enduring their same battles. IOP can be looked at as a support group of sorts.
More information on Inpatient Vs. Outpatient
Step # 4- Aftercare
Aftercare is the very last step in the rehabilitation process and there is no timeframe on it. People heal differently but one thing that all recovering addicts should be aware of is that staying sober is a lifetime gig. There is no cure for drug and alcohol addiction, there is only recovery. Recovery is always at risk for a relapse and it can take one wrong decision to lose everything that one worked so hard to obtain. Aftercare helps to make sure that won’t happen.
Aftercare means signing up and going to a support group. It means finding a sponsor and it means following the 12-step program.
- We admitted we were powerless over alcohol — that our lives had become unmanageable.
- Came to believe that a power greater than ourselves could restore us to sanity.
- Made a decision to turn our will and our lives over to the care of God as we understood him.
- Made a searching and fearless moral inventory of ourselves.
- Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
- Were entirely ready to have God remove all these defects of character.
- Humbly asked him to remove our shortcomings.
- Made a list of all persons we had harmed and became willing to make amends to them all.
- Made direct amends to such people wherever possible, except when to do so would injure them or others.
- Continued to take personal inventory and when we were wrong promptly admitted it.
- 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.
- Having had a spiritual awakening as a result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.
Aftercare also means doing things to stay away from drugs such as changing the crowd one hangs out with and finding ways to stay busy. This could be finding a new hobby, signing up for a bowling league or anything else that is positive and keeps ones mind off of drugs. Aftercare is essential part of the rehabilitation process because the patient is now flying solo which can be very intimidating.
Sober Living Houses
Some patients find sober living houses as a better option upon leaving rehab. Sober living houses are houses designed for patients who do not know if they are ready to fly freely on their own. The houses are designed just like any other house is with bedrooms, bathrooms, a kitchen and a common room. Monthly rates can be anywhere from $450-$750 a month depending on the area the patient is in.
There are rules for sober living houses such as no drugs or alcohol, no sexual relations between house guests and no smoking outside of designated areas. Residents must follow these rules or risk being evicted from the house.
Sober living houses can be a great way for someone just out of rehab to gain their footing. One doesn’t have to worry about paying utilities, just rent which leaves the option to save money toward a better, more positive future. With other residents in the house, recovery won’t seem so lonely. When patients go from the structure of RTC to flying free, it can be too overwhelming which is turn can cause a relapse. Sober living houses are a way to help patients stay away from relapse.
Addictions Are Everywhere
Drug addiction is a real problem in the United States. Heroin and prescription drug use percentages are ghastly to look at and bone-chilling when you realize that a large number of users are under 25 years of age. What’s causing the increase of drug use? Could be a number of factors but researchers have found mental illness to be a lead cause of drug addiction. Since mental illness has always been apparent throughout history, why are so many becoming addiction now? A theory is based on smartphone addiction. So many people are addicted to their phone, unable to leave it more than a few seconds, minutes or even hours at a time. Decades ago, people went outside more to do activities or even work. So many people stay indoors, on electronics and teens are usually always glued to their smartphone. Vitamin D deficiency can lead to depression and since a ton of vitamin D is found in the sun, it possible that people aren’t getting enough of it which has led to mental health issues. Mental health issues such as anxiety and depression can lead to drug use. It is a series of dominos falling and drug addiction just keeps claiming lives, even more lives than car accidents do. The drug epidemic needs to be brought down but the only way to do that is to look to its origin which starts by more people identifying that drug addiction is a problem.