Sunday, January 20, 2019

Pennsylvania

Drug Rehabilitation in Pennsylvania

Over the past 20 to 30 years, the United States has seen a widespread increase in drug addiction and substance abuse. This epidemic has affected people of all ages, from diverse backgrounds and from all walks of life, in every state across the country. Each state faces its own unique challenges, and the drug epidemic presents itself distinctly in each region of the United States due to differences in factors such as geography, accessibility to various substances, poverty and crime rates, cultural trends, and government and law enforcement solutions.
The Commonwealth of Pennsylvania is among the states with the most serious problems related to drug abuse and addiction. The Commonwealth is experiencing an unprecedented crisis of addiction and overdoses, and every region of the state has been affected. The widespread use of heroin and other opioids have become the primary focus of authorities in the Commonwealth in recent years, but other substances like alcohol, marijuana, cocaine, and prescription medications remain a concern as well. It is not only the large metropolitan cities like Pittsburgh and Philadelphia that have been struck by the substance abuse and addiction epidemic. The rural areas of Pennsylvania have also seen recent increases in drug use, addiction, and overdoses.

The Opioid Crisis and Drug Overdoses in Pennsylvania

The recent increase in drug addiction and substance abuse across the United States is a complex and multidimensional issue. Alcohol, marijuana, prescription pain relievers, depressants, and cocaine are among the most commonly abused substances in the United States, although certain substances are much more likely to be widely used in certain regions or states. Regional, cultural, and economic factors play a role in which substances are used where and by whom, and the psychological and social components of drug addiction can be difficult to untangle.
Prescription opioids and related recreational substances like heroin are among the most addictive, dangerous, and deadly substances that have taken hold in the United States. The National Institute on Drug Abuse (NIDA) estimates that, in 2015, substance use disorders involving the use of prescription opioids affected approximately 2 million Americans. Additionally, 591,000 suffered from disorders related to heroin use. In the United States, addiction to heroin and other opioids is especially prevalent in the Northeast, and Pennsylvania has among the highest rates of drug addiction and overdoses in the country.
In fact, a recent study by the Centers of Disease Control and Prevention (CDC) identified the Commonwealth of Pennsylvania as one of the five states whose rates of overdose fatalities are the highest in the nation, with 37.9 deaths from overdoses per 100,000 Pennsylvanians (more than 4,600 in total) in 2016. The keystone state was joined in this list by West Virginia, Ohio, New Hampshire, and Kentucky. Pennsylvania’s drug overdose death rate is significantly higher than the national average, which sat at 16.3 per 100,000 residents in 2015. In 2016, an estimated 13 Pennsylvanians died each day as a result of drug-related overdoses.
As is the case in many Northeastern states in the United States, heroin and other opioids are involved in the majority of these drug-related overdose fatalities. A recent report published jointly by the DEA Philadelphia Division and the University of Pittsburgh closely examined the recorded overdoses in the Commonwealth of Pennsylvania and found that, in 85 percent of drug-related overdoses in 2016, the presence of an illicit or physician-prescribed opioid was identified. Fentanyl or another related substance was identified as being present in 52 percent of drug-related deaths, while heroin was present in 45 percent of cases. Prescription opioids such as Vicodin, Percocet, and OxyContin were identified in 25 percent of deaths.
The report also revealed that young people and men are much more likely to die from a drug-related overdose in Pennsylvania. In fact, 70 percent of those who died from an overdose were male. Additionally, fentanyl (in its illicit form), heroin, and other illicit opioids were also more likely to be present in males in overdose toxicology reports, while benzodiazepines (such as alprazolam and clonazepam) and prescription opioids (such as oxycodone and hydrocodone) were more likely to be found in females.
One of the reasons behind the opioid crisis in Pennsylvania and across the entire nation is the widespread reliance on prescription pain relievers. According to the National Institute on Drug Abuse (NIDA), pharmaceutical companies in the 1990s publicly affirmed that opioid pain relievers were not addictive, and were safe to prescribe to patients who suffered from chronic pain. As a result, physicians and healthcare providers continued to prescribe these kinds of medications to their patients in greater and greater numbers. This led to the widespread misuse of prescription opioids—which can be, in reality, extremely addictive—before doctors and patients were aware of the risks.
Due to the misinformation about the addictive nature of prescription opioids, many patients recovering from surgery or taking prescription medication to cope with chronic pain became dependent on prescription opioids. If and when their physicians recognized the presence of an addiction in these patients and discontinued their prescriptions, many of those who had developed opioid dependency turned either to taking the prescriptions of family members, friends, or acquaintances, or to illicit forms of opioids.
The NIDA estimates that, of all patients in the United States who are prescribed opioid pain relievers to cope with chronic pain, approximately 25 percent misuse them, and an estimated 5 percent of those who do so eventually transition to using heroin.
In addition to prescription opioid and heroin addiction, alcohol, marijuana, and cocaine are among the most frequently abused drugs in the Commonwealth of Pennsylvania, although heroin and cocaine have seen the sharpest increases in addiction and treatment rates in the state in recent years.

Pennsylvania Cities Affected by Addiction

  • Abington Township
  • Allentown
  • Altoona
  • Bensalem Township
  • Bethel Park
  • Bristol Township
  • Cheltenham Township
  • Chester
  • Cranberry Township
  • Easton
  • Erie
  • Exeter Township
  • Haverford Township
  • Lancaster
  • Lebanon
  • Lower Merion Township
  • Lower Paxton Township
  • Lower Providence
  • Township
  • Manheim Township
  • McCandless
  • Middletown Township
  • Millcreek Township
  • Monroeville
  • Montgomery Township
  • State College
  • Norristown
  • North Huntington
  • Penn Hills
  • Philadelphia
  • Pittsburgh
  • Plum
  • Reading
  • Ridley Township
  • Ross Township
  • Scranton
  • Spring Township
  • Springettsbury Township
  • Upper Darby Township
  • Upper Merion Township
  • Warminster Township
  • Williamsport York

Crime and Addiction in the Commonwealth

Addiction to drugs, alcohol, and other substances can take hold of every aspect of a person’s life. As previously discussed, drug-related overdoses are a serious concern in Pennsylvania and across the United States, particularly when heroin or other opioids are involved. Continued abuse of and dependence on drugs and alcohol can also lead to mental, physical, and social issues for the addicted person and negatively influence nearly every aspect of his or her life, and the lives of families, friends, and acquaintances.
The kind of widespread use of drugs and alcohol that the United States has experienced in recent decades can also place a tremendous burden on entire communities and society in general. There is a clear link between the prevalence of drug and alcohol addiction in a particular area and criminal activity. This is not to say that every addict is a criminal. The correlation between crime and drug abuse is complex and dynamic. Many who are addicted to illegal drugs will never commit a crime of another nature, and many criminals never use or abuse drugs. However, crime and the widespread use of drugs and alcohol are undeniably linked in the Commonwealth of Pennsylvania, across the United States, and around the world.
Those who suffer with addiction may act in ways that they never would otherwise while they are under the influence of these drugs. In addition, drug cartels and gang activity are commonly associated with the supply of illicit drugs in the United States, so increases in cartel- and gang-related crime are strongly correlated with the widespread abuse of drugs.
The National Council on Alcoholism and Drug Dependence (NCADD) estimates that 80 percent of crimes that lead to incarceration in the United States somehow involve the use of drugs and alcohol. These crimes include, but are not limited to, the following:


Drug sale/possession
Driving under the influence
Larceny/theft
Burglary
Robbery
Fraud
Public disturbance
Destruction of property
Prostitution
Domestic abuse
Child abuse
Aggravated assault
Sexual assault
Homicide

Crimes involving the use, sale, or distribution of drugs or alcohol affect the lives of millions of Americans each year. A tremendous burden is placed on local, state, and federal law enforcement, the accompanying legal systems, and the jail and prison systems in communities where alcohol, drugs, and crime have taken hold. Most importantly, the lives of addicted individuals who commit or are the victims of these drug-related crimes are negatively impacted, as are the lives of their families, friends, and loved ones.
The National Council on Alcoholism and Drug Dependence (NCADD) estimates that 80 percent of all criminal offenders in the United States abuse alcohol and/or drugs, and that 60 percent of those arrested for the kinds of crimes listed above are under the influence of illegal drugs at the time they are arrested. Additionally, approximately 50 percent of those in jail or serving prison sentences are clinically addicted to drugs or alcohol.
Driving under the influence of alcohol or other substances continues to be a major cause of death in the United States, and a major concern for law enforcement. Each year, over one million people are arrested for driving while under the influence of alcohol. A few years ago, the Centers for Disease Control and Prevention (CDC) conducted and compiled research related to drunk driving and alcohol related deaths across all states.
In the United States, a driver is considered alcohol-impaired by law if they have a blood alcohol concentration (BAC) of 0.08 percent or higher. Approximately one third of all traffic deaths across the country involve a driver who is legally alcohol-impaired. According to the CDC, between 2003 and 2012 there were 4,663 fatalities as a result of accidents involving drunk drivers in the Commonwealth of Pennsylvania, and approximately 2 percent of Pennsylvanians surveyed reported that they had driven a vehicle after drinking too much within the past month.
Alcohol- and drug-related crimes are preventable. Alcohol and other frequently-abused substances lower inhibitions, increase the likelihood of dangerous, risky, and violent behavior, and prevent those under their influence from carefully reasoning and considering the consequences of their actions. Ensuring that those addicted to these substances have access to addiction treatment, and are encouraged to get the help they need, is the most effective way to combat not only the harmful effects of addiction on individuals and their loved ones, but the crimes associated with widespread substance abuse as well.

Alcoholism and Underage Drinking

In the United States, alcohol is the third most common preventable cause of death. It is estimated that, each year, approximately 88,000 people die from causes related to the use of alcohol.
Many of these alcohol-related fatalities, and other injuries and illnesses involving the use of alcohol, occur as a result of binge-drinking. In a recent study by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), almost a third of adult Americans surveyed said they engaged in at least one episode of binge drinking (defined in the study as drinking enough alcohol to raise an individual’s blood alcohol concentration to 0.08 percent or higher) within the last 30 days. In the same study, approximately 7 percent of those surveyed also said they engaged in heavy alcohol use (defined as binge drinking 5 or more days per month) during this same 30-day period.
The short-term, immediate effects of binge drinking can include warped thinking patterns, disturbed sleep, delayed reflexes, poor coordination, impairments in judgement and memory, decreased control of motor functions, and blackouts. Over time, continued heavy drinking breaks down the body and can cause long-lasting or even permanent damage to the brain and liver. Long-term heavy drinking has also been linked to breast and pancreatic cancer in addition to a variety of chronic stomach, bone, and heart conditions. It should be noted that the negative effects of binge and heavy drinking are not only physical. Alcohol abuse is also linked with anxiety and depression, social isolation and withdrawal, risky and violent behavior, and suicide.
In addition to their research on adults, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) also surveyed those under the age of 18 and found that, although teenagers were less likely to report binge drinking and heavy alcohol use compared to adults, a significant number of those surveyed had engaged in these behaviors within the past 30 days. Approximately 13.4 percent of underage respondents said they had engaged in binge drinking during this period, while 3.3 percent had engaged in the heavy use of alcohol. Of those surveyed, 20.3 percent of underage respondents said they had at least one drink during the last 30 days.
Although teen respondents in the NIAAA survey were less likely than adults to report binge drinking, according to the Centers for Disease Control and Prevention (CDC), those under the age of 18 tend to consume more alcohol per sitting than adults. In fact, an estimated 90 percent of all underage drinking in the United States is done in the form of binge drinking. This may be partially explained by the prevalence of alcohol at weekend parties attended by high school students, and by the tendency for teenagers to try to hide their use of alcohol from parents and/or other adults.

Alcoholism and Underage Drinking

The risks and dangers associated with drinking alcohol, and particularly binge drinking and heavy drinking, are far higher for teenagers than for adults. Those who begin drinking alcohol before they reach adulthood are significantly more likely to develop unhealthy drinking habits and alcohol dependence, and continue to engage in binge and heavy drinking into adulthood, than those who do not.
As previously discussed, long-term alcohol abuse can cause long-term, serious damage to the brain, liver, pancreas, stomach, heart, and bones, and is correlated with increased risk of anxiety, depression, social isolation, and risky and/or violent behaviors. During the teen years and into early adulthood, the body and mind are still developing, and the heavy use of alcohol can seriously interfere with the important stages of development that take place during these years.
In addition to the negative physical effects of alcohol on young people, there are a variety of other risks and problems associated with underage drinking. Teenagers who engage in underage drinking are significantly more likely to experience a number of social, academic, and psychological problems, such as:
Abuse of or dependence on other substances
Poor grades or risk of dropping out of school
Physical fights or confrontations
Physical or sexual assault
Driving under the influence
Depression, changes in mood, anxiety, and memory problems

Underage Drinking in Pennsylvania

The risks and dangers associated with drinking alcohol, and particularly binge drinking and heavy drinking, are far higher for teenagers than for adults. Those who begin drinking alcohol before they reach adulthood are significantly more likely to develop unhealthy drinking habits and alcohol dependence, and continue to engage in binge and heavy drinking into adulthood, than those who do not.
As previously discussed, long-term alcohol abuse can cause long-term, serious damage to the brain, liver, pancreas, stomach, heart, and bones, and is correlated with increased risk of anxiety, depression, social isolation, and risky and/or violent behaviors. During the teen years and into early adulthood, the body and mind are still developing, and the heavy use of alcohol can seriously interfere with the important stages of development that take place during these years.
In addition to the negative physical effects of alcohol on young people, there are a variety of other risks and problems associated with underage drinking. Teenagers who engage in underage drinking are significantly more likely to experience a number of social, academic, and psychological problems, such as:
Abuse of or dependence on other substances
Poor grades or risk of dropping out of school
Physical fights or confrontations
Physical or sexual assault
Driving under the influence
Depression, changes in mood, anxiety, and memory problems

Legal Consequences of Drug and Underage Alcohol Possession and Use in Pennsylvania

The Commonwealth of Pennsylvania regulates the possession and use of alcohol and medical marijuana, and prohibits the recreational use of marijuana, prescription drugs, and other controlled substances, including heroin, cocaine, amphetamines, and methamphetamines.
Alcohol
Buying, possessing, or consuming alcohol in the Commonwealth of Pennsylvania while under the age of 21 is prohibited and can result in a jail sentence of up to 90 days, fines of up to $500, and a suspended driver’s license for up to 90 days. The severity of the punishment for underage drinking depends on whether it is the first offence or a subsequent offence. Those who are caught drinking under the age of 21 three or more times may have their driver’s licenses suspended for up to two years and face a fine of $1,000.
Driving under the influence in Pennsylvania also carries heavy penalties, and sentences are broken down based upon a driver’s blood alcohol concentration (BAC) at the time of their arrest. According to the state’s DMV.org website, “general impairment” means a BAC between 0.08 percent and 0.099 percent. First time offenders face 6 months of probation and a fine of $300 and must attend alcohol treatment and highway safety school. Drivers with a BAC over 0.10 and those driving under the influence of a controlled substance can face up to 6 months in prison and fines of up to $5,000, in addition to having their licenses suspended for a year and attending highway safety school and treatment for alcohol.
Marijuana
Medical marijuana use is legal in Pennsylvania for those who suffer from a serious medical condition who have obtained a prescription through a licensed physician. Medical conditions included in the state’s definition include, but are not limited to:

Autism
Cancer
Crohn’s disease
Epilepsy
HIV/AIDS
Huntington’s disease
IBS
Multiple sclerosis
Parkinson’s disease
PTSD
Sickle cell anemia

The use of any amount of marijuana for non-medical purposes is prohibited in the Commonwealth of Pennsylvania. According to the Crimes Code of the Commonwealth of Pennsylvania, those arrested with less than 30 grams of marijuana face up to 30 days in jail and fines of up to $500, while those arrested with greater than 30 grams face up to a year in jail and fines of up to $5,000. Those arrested with 30 grams or more of marijuana also face a 6 month suspension of their driver’s licenses and may also face additional charges if they are suspected of having intent to deliver or distribute.

Other Controlled Substances Such as Heroin, Cocaine, and Prescription Drugs

As previously discussed, Pennsylvania continues to face serious issues related to the use of illicit substances, particularly heroin and other opioids. Each day, approximately 13 people die as a result of drug-related overdoses in the Commonwealth of Pennsylvania. Due to the additional risks and dangers for both individuals and the greater community that are associated with the use illicit substances such as heroin, cocaine, and prescription drugs, sentences for the possession and use of such drugs are more severe than for marijuana.
The Pennsylvania crimes code indicates that first-time offenders arrested with illicit drugs face up to a year in prison and fines of up to $5,000. A second offence can carry a two year prison sentence, while those who commit a third offence can face up to three years in prison.

Pennsylvania’s Drug Courts

Many states offer drug court programs as a way to help those convicted of drug-related crimes receive the treatment they need under careful supervision. Instead of receiving a jail or prison sentence, those convicted of nonviolent crimes are able to receive treatment, rehabilitation, counseling, and other recovery services while being monitored by judicial and medical professionals.
Pennsylvania drug courts partner with drug treatment professionals and providers, probation officers, and law enforcement and typically involve regular court appearances and mandatory drug testing, with the primary goal of rehabilitation and recovery. Learn more about Pennsylvania’s drug court program here.

State Initiatives Focused on Drug and Alcohol Abuse

As previously discussed, Pennsylvania has one of the highest rates of overdose deaths in the United States, and overdose fatality rates are especially high when heroin and other opioids are present. State authorities have taken a number of steps to address the crisis of drug-related fatalities and substance abuse and addiction in the Commonwealth of Pennsylvania.
Pennsylvania’s Department of Drug and Alcohol Programs (DDAP) separated from the state’s Department of Health in 2012 to become its own department, with the goal of addressing the ongoing epidemic of drug overdoses and drug and alcohol addiction and abuse, while advocating for treatment and recovery. A few prominent initiatives are listed below:

Opioid Overdose Reversal Act 139

As previously discussed, Pennsylvania has one of the highest rates of overdose deaths in the United States, and overdose fatality rates are especially high when heroin and other opioids are present. State authorities have taken a number of steps to address the crisis of drug-related fatalities and substance abuse and addiction in the Commonwealth of Pennsylvania.
Pennsylvania’s Department of Drug and Alcohol Programs (DDAP) separated from the state’s Department of Health in 2012 to become its own department, with the goal of addressing the ongoing epidemic of drug overdoses and drug and alcohol addiction and abuse, while advocating for treatment and recovery. A few prominent initiatives are listed below:

Pennsylvania’s “Warm Hand-off” Policy

Addressing the overdose epidemic is a major concern for Pennsylvania authorities. In addition to David’s Law, which attempts to save the lives of individuals in the process of a drug overdose, the state has also taken steps to try to ensure that those whose lives are saved also get the treatment they require. The Commonwealth’s DDAP and its recently established Overdose Task Force have developed a policy that allows those who have survived a drug overdose to be moved directly from the hospital or emergency room where they receive medical care to an addiction treatment center. Under this “warm hand-off” policy, overdose survivors in Pennsylvania may receive immediate counseling and be referred by a doctor to a treatment facility, where they can begin rehabilitation and recovery.

Prescription Drug Monitoring Program (PDMP)

As previously discussed, pharmaceutical companies in the late 1990s insisted that opioid pain relievers were not addictive. This contributed to the widespread abuse of prescription medications in the United States, which is a primary driver behind the current opioid epidemic in the Commonwealth of Pennsylvania and across the country. In response to the prescription drug abuse crises, many states have implemented drug monitoring programs in order to better understand how drugs are prescribed by physicians and used by patients, so as to prevent misuse and abuse of these drugs.
Pennsylvania’s Drug Monitoring Program (PDMP) is designed to monitor prescription drugs through a statewide database with the goal of identifying the abuse of prescription opioids and other medications. State authorities work with health care providers, physicians, and clinics in the Commonwealth to educate health care professionals on how to identify substance use disorders in patients and ensure they get the treatment they need.

Prescription Drug Take-Back Program

The more prescription medications there are sitting in drawers and cabinets across the Commonwealth of Pennsylvania, the more opportunities there are for people to begin misusing or abusing them, and the likelihood increases that individuals may develop dependency on these medications.
In addition to monitoring prescription opioids and other drugs, Pennsylvania authorities have also recently expanded an existing take-back program in order to limit the amount of opioids and other prescription medications there are in the community that may be abused or misused. The program places take-back boxes all across Pennsylvania, where citizens are encouraged to take and drop-off medications that they no longer use. In 2015 and 2016, more than 100,000 pounds of prescription medications were collected and destroyed under this program.

What is Addiction?

In the United States, addiction is most often discussed in social, legal, and moralistic terms. Public conversations about addiction and substance abuse tend to focus on behaviors, consequences, and the societal effects of widespread abuse of drugs and alcohol. These conversations rarely include accurate discussions of how addiction affects the internal and external lives of those who suffer with it, or how drug abuse and addiction affect the lives of their family, friends, and loved ones.
There are a fair number of misconceptions about drug and alcohol addiction in the United States and around the world. It can be difficult for those who have not suffered from addiction themselves or worked with addicted individuals to comprehend the influence and control that addictive substances can have over those who use them.
Addiction is a complex and dynamic brain disease that causes a compulsive use of harmful substances, the continued use of which can interfere with nearly every aspect of an individual’s life and physical, psychological, and social health and wellbeing. The intense need to keep using drugs or alcohol often interferes with work or school responsibilities, relationships, and physical health, and it is common for those with addiction to be unaware of the depth of their addiction and how it is affecting their lives.
Substances that are addictive in nature include, but are not limited to:

Alcohol
Marijuana
Opiates such as heroin, opium, and morphine
Opioids such as oxycodone and fentanyl
Hallucinogens such as PCP and LSD
Sedatives and tranquilizers
Cocaine and crack cocaine
Meth (crystal meth and methamphetamines)
Tobacco
It is common for conversations about addiction to revolve around the “choices” that individuals make to use drugs or alcohol. This is in incomplete and often inaccurate depiction of the dynamics of addiction. The truth is that, once a person has become chemically or psychologically addicted to a substance, choice has little to do with the relationship the addicted person has with drugs or alcohol.
Addiction takes hold of the mind and body over time as repeated use of addictive substances interferes with and changes the brain chemistry of the addicted person. The brain is rewired as the dependency develops, causing intense, powerful cravings for the drug or other substance. According to the American Psychiatric Association (APA), addiction causes disruptions and changes in the regions of the brain responsible for behavior control, judgement, decision making, learning, and memory. These changes are observable on brain imaging scans. Unlike the immediate, short-term effects of addictive substances, these chemical and functional changes in the brain of the addicted person can be long-lasting and even permanent.
Many people who suffer with addiction are first introduced to addictive substances in social or recreational settings. Young people and teens are perhaps particularly susceptible to the social pressure to experiment with drugs and alcohol, since peer pressure is common among teens and young adults and it is common for high school and college students to hide their use of drugs and alcohol from parents, school administrators, and other adults. Many other people, and particularly those addicted to opioids and other prescription medications, are introduced to addictive drugs after having received a prescription from a physician or using medication prescribed to a family member, friend, or acquaintance.
Often, those who become addicted to prescription medications develop a dependency before they are even aware of it, and it is not uncommon for those addicted to prescription opioids to transition from prescription medication to illicit forms of the drug, such as heroin.
Some substances are much more addictive than others, and not everyone is equally susceptible to becoming addicted. Scientists have long debated the respective roles of “nature vs. nurture,” trying to determine if human behavior is better explained by biological and genetic factors or by social and environmental ones. Over time, ongoing research and analysis has led the majority of researchers and clinicians to believe that human behavior and human health is the result of both nature and nurture.
Not only do both environmental and biological factors play a role in the likelihood that a particular individual may become addicted to a substance they come into contact with, but it is the dynamic interaction between an individual’s biological makeup and their physical and social environment that predicts the likelihood that they may develop a dependence on drugs or alcohol.
It has long been understood and accepted that social and environmental factors also contribute to the likelihood that a person may develop a dependence on drugs or alcohol. Lack of parental supervision, peer pressure, community poverty, and the use of drugs or alcohol by friends or family members can all contribute to the risks that a person may develop a substance addiction.
Although the environmental components of addiction are widely acknowledged, researchers and clinicians are just beginning to understand and appreciate the profound role that genetics plays in addiction. Recent studies have demonstrated that genetics play an extremely important role in determining the likelihood that a particular individual will develop a dependence on drugs or alcohol. In fact, according to the National Institute on Drug Abuse (NIDA), approximately half of an individual’s risk of substance abuse and dependency can be attributed to his or her genetic makeup.
Ultimately, it is the dynamic interaction between a person’s biological and psychological makeup and their physical and social environment that determines their likelihood to develop dependency. Other factors, such as the age and stage of development at which a person comes into contact with a particular substance and the presence of mental health disorders, also play important roles.

Symptoms of Drug and Alcohol Addiction

In the United States, addiction is most often discussed in social, legal, and moralistic terms. Public conversations about addiction and substance abuse tend to focus on behaviors, consequences, and the societal effects of widespread abuse of drugs and alcohol. These conversations rarely include accurate discussions of how addiction affects the internal and external lives of those who suffer with it, or how drug abuse and addiction affect the lives of their family, friends, and loved ones.
There are a fair number of misconceptions about drug and alcohol addiction in the United States and around the world. It can be difficult for those who have not suffered from addiction themselves or worked with addicted individuals to comprehend the influence and control that addictive substances can have over those who use them.
Addiction is a complex and dynamic brain disease that causes a compulsive use of harmful substances, the continued use of which can interfere with nearly every aspect of an individual’s life and physical, psychological, and social health and wellbeing. The intense need to keep using drugs or alcohol often interferes with work or school responsibilities, relationships, and physical health, and it is common for those with addiction to be unaware of the depth of their addiction and how it is affecting their lives.
Substances that are addictive in nature include, but are not limited to:

Alcohol
Marijuana
Opiates such as heroin, opium, and morphine
Opioids such as oxycodone and fentanyl
Hallucinogens such as PCP and LSD
Sedatives and tranquilizers
Cocaine and crack cocaine
Meth (crystal meth and methamphetamines)
Tobacco
It is common for conversations about addiction to revolve around the “choices” that individuals make to use drugs or alcohol. This is in incomplete and often inaccurate depiction of the dynamics of addiction. The truth is that, once a person has become chemically or psychologically addicted to a substance, choice has little to do with the relationship the addicted person has with drugs or alcohol.
Addiction takes hold of the mind and body over time as repeated use of addictive substances interferes with and changes the brain chemistry of the addicted person. The brain is rewired as the dependency develops, causing intense, powerful cravings for the drug or other substance. According to the American Psychiatric Association (APA), addiction causes disruptions and changes in the regions of the brain responsible for behavior control, judgement, decision making, learning, and memory. These changes are observable on brain imaging scans. Unlike the immediate, short-term effects of addictive substances, these chemical and functional changes in the brain of the addicted person can be long-lasting and even permanent.
Many people who suffer with addiction are first introduced to addictive substances in social or recreational settings. Young people and teens are perhaps particularly susceptible to the social pressure to experiment with drugs and alcohol, since peer pressure is common among teens and young adults and it is common for high school and college students to hide their use of drugs and alcohol from parents, school administrators, and other adults. Many other people, and particularly those addicted to opioids and other prescription medications, are introduced to addictive drugs after having received a prescription from a physician or using medication prescribed to a family member, friend, or acquaintance.
Often, those who become addicted to prescription medications develop a dependency before they are even aware of it, and it is not uncommon for those addicted to prescription opioids to transition from prescription medication to illicit forms of the drug, such as heroin.
Some substances are much more addictive than others, and not everyone is equally susceptible to becoming addicted. Scientists have long debated the respective roles of “nature vs. nurture,” trying to determine if human behavior is better explained by biological and genetic factors or by social and environmental ones. Over time, ongoing research and analysis has led the majority of researchers and clinicians to believe that human behavior and human health is the result of both nature and nurture.
Not only do both environmental and biological factors play a role in the likelihood that a particular individual may become addicted to a substance they come into contact with, but it is the dynamic interaction between an individual’s biological makeup and their physical and social environment that predicts the likelihood that they may develop a dependence on drugs or alcohol.
It has long been understood and accepted that social and environmental factors also contribute to the likelihood that a person may develop a dependence on drugs or alcohol. Lack of parental supervision, peer pressure, community poverty, and the use of drugs or alcohol by friends or family members can all contribute to the risks that a person may develop a substance addiction.
Although the environmental components of addiction are widely acknowledged, researchers and clinicians are just beginning to understand and appreciate the profound role that genetics plays in addiction. Recent studies have demonstrated that genetics play an extremely important role in determining the likelihood that a particular individual will develop a dependence on drugs or alcohol. In fact, according to the National Institute on Drug Abuse (NIDA), approximately half of an individual’s risk of substance abuse and dependency can be attributed to his or her genetic makeup.
Ultimately, it is the dynamic interaction between a person’s biological and psychological makeup and their physical and social environment that determines their likelihood to develop dependency. Other factors, such as the age and stage of development at which a person comes into contact with a particular substance and the presence of mental health disorders, also play important roles.

The Purpose of Drug and Alcohol Treatment

As previously discussed, continued abuse of drugs or alcohol eventually changes the chemistry and wiring of the human brain, causing a compulsive, intense need to return to the addictive substance, often in increasing amounts and with increased frequency. For those who suffer from addiction, attempting to stop using drugs or alcohol can be physically and psychologically grueling, and even dangerous. Although, in some instances, it may be possible for an individual to stop using drugs or alcohol on their own, many people require some form of organized treatment.
The purpose of treatment is, simply put, to help those who are physically and/or psychologically addicted to drugs or alcohol stop abusing the substance to which they are addicted; however, effective recovery involves much more than that. Addiction is a complex brain disease that can interfere with every aspect of a person’s life, from academic or professional responsibilities, to relationships with family, friends, or partners, to the physical and psychological health of the addicted person. Additionally, many people initially begin misusing drugs or alcohol in response to anxiety or stress, past trauma, depression, or other emotional or psychological hardship. Often, there are underlying emotional, mental, psychological, or social factors that must be addressed in addition to the behavioral and physical aspects of addiction.
In addition to helping addicted individuals stop abusing drugs or alcohol, effective treatments address these underlying factors that may have contributed to the substance dependency in the first place or may have developed as a result of the addiction. It is important that these issues are addressed during recovery so that the individual that has undergone treatment can return to their lives, their loved ones, their workplaces, and their communities in a stable, healthy condition. Effective treatment will not only involve learning to live without drugs or alcohol, but will also teach coping strategies, cultivate and nurture healthy thinking patterns, and help individuals form long-lasting, supportive relationships with peers.
Treatment for drug and alcohol addiction has been shown to be effective. Research that has tracked people who have undergone treatment over time indicates that most people who complete drug treatment are able to stop abusing drugs, decrease criminal activity, and increase their social, occupational, and mental well-being.
Just as each person who suffers with addiction suffers individually and faces his or her own unique struggles and challenges, no single type of treatment is right for everyone. Treatment is not a “one-size-fits-all” solution, and treatments are most effective when individualized and appropriately matched to the unique needs of the individual.
Factors that may influence the type of treatment an individual requires may include, but are not limited to:

The substance(s) abused
The quantity used
The frequency of use
The duration of the addiction
The level of physical dependency
The level of psychological dependency
Past traumas
Support systems
Co-occurring mental and physical health issues


It is important to note that it is not necessary for an individual to voluntarily enter treatment in order for it to be effective. Sanctions and/or appeals from family members, friends, colleagues, acquaintances, counselors, physicians, and/or the criminal justice system can not only help to ensure that those who suffer from substance dependence and addiction enter treatment, but they can also improve retention rates of those in treatment, and aid in the effectiveness of treatment.

Intervention

Not everyone who enters a rehabilitation facility or treatment center for drug or alcohol abuse does so following an intervention. Some people come to the conclusion that they require treatment for their addiction on their own. In other cases, an informal conversation between the addicted person and a concerned loved one is enough to lead him or her to seek treatment. However, in many cases, a formal intervention organized by the addicted individual’s family, friends, or loved ones is required.
Because people suffering from addiction may be in denial about their dependency on drugs or alcohol, a formal, structured approach is sometimes needed to help them see that their actions are negatively impacting their lives and the lives of those around them. Interventions are usually initiated and organized by the person’s family, friends, and loved ones, and a licensed drug or alcohol counselor or professional interventionist is sometimes involved. In some cases, a priest, pastor, rabbi, imam, or other respected member of the person’s faith is involved as well.
The purpose of an intervention for drug or alcohol addiction is to:
Convince the person that he or she is suffering from an addiction
Provide specific examples of how the addiction is negatively impacting his or her life and the lives of loved ones
Persuade the addicted person to accept treatment
Explain what each person will do (or stop doing) if the person refuses treatment
It is important for any intervention to address the concerns and worries of the addicted individual. For many people who suffer with addiction, the idea of treatment is intimidating or even frightening. Substance addiction changes brain chemistry and functioning over time, and disrupts and interferes with thinking patterns that allow the addicted person to go without the substance. For those with severe and/or long-lasting addictions or those dependent upon highly addictive and destructive substances like heroin, the thought of not using drugs or alcohol can be unimaginable.
In addition to the fear of going without the addictive substance, most people have concerns about other aspects of undergoing treatment. In cases where inpatient treatment is required or recommended, many people worry about how long they will be away from family, work, or other obligations, and who will take care of dependents, pets, bills, and other responsibilities. Additionally, it is common for those considering entering treatment to worry about the physical and psychological pain associated with detox and withdrawal and struggle with the thought of opening up during counseling or group therapy.
For those who have never undergone treatment for drugs or alcohol before, treatment and recovery is an unknown. For an intervention to be effective, it is important for all of these concerns to be listened to and taken seriously. In many cases, a detailed treatment plan with specific goals has been prearranged prior to the intervention, so all the addicted person has to do is say “yes” to receiving treatment. When this is the case, loved ones and/or a therapist or psychologist who has helped to organize the intervention may be able to ease some of these concerns and worries by answering any questions the person may have about how treatment works.

Pre-Intake

Once an individual has made the decision to enter treatment for alcohol or drug addiction—either on his or her own or following an intervention by family, friends, and/or loved ones—there are some important things to consider and take care of before entering the treatment facility. These typically include:
Care of any children or dependents while the person is in treatment
Care of his or her pets
Notifying his or her loved ones
Notifying his or her employer(s) and/or school(s)
Paying for treatment
Plans following treatment for aftercare, continuing sobriety, and returning to everyday life
In many cases, spouses, family members, friends, or other loved ones can take care of most of these details so that the addicted person can fully focus on entering treatment, detoxing, and getting well. As previously discussed, entering treatment can be a very emotionally, physically, and psychologically trying task. Recovery from dependence on drugs or alcohol takes a great deal of dedication, attention, and time. It is important for those undergoing treatment to be able to focus on recovery. Ensuring that the practical details have been taken care of ahead of time can go a long way in allowing an addicted person to fully turn their attention to treatment and getting well.
It is important to note that The Family and Medical Leave Act (FMLA) entitles employees to up to 12 weeks of medical leave for a serious health condition and these can be used for substance abuse and addiction treatment.
In addition to taking care of many of these practical concerns prior to entering treatment, it is also important to gain as much information as possible about what to expect from treatment, and to understand any particular requirements, expectations, or policies a particular treatment facility or program may have. Every rehabilitation center is different in terms of rules and expectations, so it is important to understand what these are upon entering treatment. Although rules and requirements differ, all facilities will typically provide new patients with a list of restricted items that cannot be brought into treatment. These typically include, but are not limited to:
Drugs and alcohol
Cell phones, laptops, tablets, and other electronics
Weapons
Expensive belongings and cash
Unapproved medications
Flammable objects
Products containing alcohol (toiletries, etc.)
New patients are asked to leave these and other restricted items at home or with loved ones during treatment or to turn them in to the center’s administrative staff during the intake process.
Most inpatient treatment centers also have rules about visiting hours, mandatory attendance at group therapy or counseling appointments, and restrictions on where patients can go. Most inpatient treatment programs require patients who leave the facility for any reason to be accompanied by a staff member. It is important to understand all of these additional rules and expectations before entering treatment, or during the intake process.

Assessment and Intake

Every rehabilitation facility has its own unique set of processes and procedures that must be completed each time a new patient enters treatment. There are, however, some standard intake procedures that most treatment centers follow.
Upon arriving at a rehabilitation center, medical personnel and other trained staff will typically perform an initial drug assessment to determine what substances the person is currently abusing and the extent and severity of his or her addiction. Depending on the facility, clinicians may also perform a comprehensive medical exam, and new patients will be asked to submit to a breathalyzer, urine sample, and drug test and to provide detailed information about their medical history and the medical histories of their families.
Almost all treatment centers also arrange for new patients to meet individually with a certified counselor to discuss the patient’s past and current experiences with substance abuse, mental health history, underlying health issues, and goals for treatment. These one-on-one meetings with counselors during the intake process also allow new patients to ask any questions they may have and voice their concerns or fears about treatment. Additionally, these meetings give the counselor the opportunity to evaluate the severity of a new patient’s psychological and physical addiction, begin to identify possible underlying causes of the addiction, and develop a specific and individualized treatment plan based on the particular needs of the new patient.
In addition, the assessment process typically involves some combination of self-reported survey tools which help clinicians assess the patient’s behavioral and mental health, and aid in the development of an individualized treatment plan. According to The Substance Abuse and Mental Health Services Administration (SAMHSA), the following surveys are commonly used in drug assessments:
Substance Abuse Subtle Screening Inventory (SASSI)
The SASSI is a psychological questionnaire that helps psychologists and clinicians determine if a patient is suffering from a substance dependence disorder.
Alcohol Use Disorders Identification Test (AUDIT)
The AUDIT is a 10-item self-reported survey developed by the World Health Organization (WHO). It helps psychologists and clinicians assess patient’s drinking behaviors and patterns and identify alcoholism.
CAGE Questionnaire
The CAGE questionnaire consists of 4 questions and helps psychologists and clinicians identify alcoholism in patients.
Mental Health Assessment
Many facilities will also perform a comprehensive mental health assessment to help identify any existing mental health disorders or symptoms. Mental health assessments are conducted by trained mental health professionals who may administer a number of surveys, screening forms, and other tools to identify depression, anxiety, personality and/or mood disorders, PTSD, and other mental health issues.
Once the assessment process is completed, new patients are usually given a tour of the facility, during which they are shown where they will eat, sleep, participate in counseling and group therapy, etc. Patients are also provided with additional information about the center’s rules and expectations, and will typically be given hand-outs that detail the particular rules. This is also when patients should ask any questions they have about what to expect.
As previously discussed, most treatment centers have a list of restricted items that cannot accompany patients into treatment. Either prior to or during the assessment and intake process, most rehabilitation centers will have a staff member go through a new patient’s belongings and packed bags with them to ensure that they do not have any restricted items with them.
Once a new patient has toured the facility, he or she is generally provided with a meal and allowed to relax in his or her new room, unpack clothes and belongings, and get settled in. Many treatment centers have shared rooms, so it is common for individuals undergoing inpatient treatment to have a roommate, whom they will typically meet on the tour of the center, during dinner, or at some point in their new room. New patients may also be invited to attend a group therapy session or meeting, but it is generally not required on the first day.

Detox and Withdrawal

Detoxification is defined as the time period during which an addicted person first stops using drugs or alcohol in order to rid the body of physical dependence and the toxins and chemicals that accompany the addiction. It is one of the first and most important steps of treatment for drugs or alcohol abuse.
After a certain amount of time without the addictive substance, those who suffer from dependence on drugs or alcohol generally begin to experience symptoms of withdrawal. The addicted person’s body has become accustomed to regular doses of drugs or alcohol, and when it does not receive its usual dose, the brain responds. It is common for those undergoing detox to experience the extreme opposite symptoms that the addictive substance produces.
The detoxification and withdrawal process differs greatly from person to person depending upon the substance(s) used and abused, the severity of the addiction, the duration of the addiction, the method of abuse (swallowing, smoking, injecting, etc.), biological and genetic factors, and the addicted person’s existing physical and mental health. These and other factors influence the symptoms and timelines associated with withdrawal and detox from alcohol and other drugs.

Heroin and Other Opioids

As previously discussed, heroin and other opioids like OxyContin, methadone, Vicodin, and Percocet are considered to be highly addictive. They are some of the hardest substances to stop using and the process of withdrawing from them can be dangerous and, in extreme cases, life-threatening. Because of this, it is highly recommended that people detoxing from heroin and other opioids do so in a controlled environment and be medically monitored by clinicians and other healthcare professionals throughout the process.
According to the National Institute on Drug Abuse (NIDA), opioid withdrawal symptoms may begin within the first few hours after the drug is last used and include both mental/psychological and physical symptoms. Major withdrawal symptoms typically peak between 24 and 48 hours after the last use of the drug, and can last anywhere from 7 to 10 days. In some stubborn cases, withdrawal symptoms can be present for months, though they typically decrease in severity over time.
Common symptoms of heroin and other opioid withdrawal include, but are not limited to, the following:

Restlessness and hyperactivity
Insomnia
Dehydration
Sweating
Yawning
Runny nose
Nausea and vomiting
Diarrhea
Muscle aches and spasms
Goose bumps and chills
Aggression and irritability
Anxiety, paranoia, and hallucinations
High blood pressure
Drug cravings
Dilated pupils
Depression

Alcohol

Alcohol is the single most commonly abused substance in the United States, with 17.6 million people, or 1 in every 12 adults, suffering from alcoholism, according to the National Council on Alcoholism and Drug Dependence (NCADD). Approximately 88,000 deaths are attributed to alcohol abuse each year, and alcoholism is the third leading lifestyle-related cause of death in the United States.
Alcohol withdrawal is different from patient to patient and symptoms can range from minor hangover symptoms to severe, life-threatening symptoms depending on the severity and duration of the addiction and abuse. Symptoms may begin within the first few hours following the patient’s last drink and are most intense during the first 3 to 4 days, usually tapering off within a week.
Common symptoms of alcohol withdrawal include, but are not limited to, the following:
Anxiety and/or depression
Headache
Irritability
Fatigue
Dehydration
Loss of appetite
Difficulty concentrating
Insomnia
Pale and/or clammy skin
Mood changes
Night terrors
Sweating
Nausea and vomiting
Shortness of breath
Shakiness
In severe cases, alcohol withdrawal can be life-threatening due to a condition that can develop in those undergoing detox, called delirium tremens (DTs). Not all people detoxing from alcohol will develop DTs, but the condition is potentially fatal and requires immediate medical attention. For this reason, it is highly recommended that anyone withdrawing from alcohol following sustained, long-term abuse do so in an inpatient setting where he or she can be monitored by clinicians and other medical professionals.
According to the National Institute of Health, symptoms of DTs include:

Seizures
Fever
Delirium (sever confusion)
Hallucinations
Body tremors
Agitation/irritability
Restlessness
Stupor
Deep sleep

Cocaine

Cocaine is a stimulant drug, and stimulant withdrawal is different from withdrawal from other substances such as heroin and alcohol in that most of the symptoms are psychological and emotional as opposed to physical. For this reason, cocaine withdrawal is not considered life-threatening, although it is important to note that suicidal thoughts can occur in severe cases.
Drug cravings and emotional symptoms during cocaine withdrawal can be severe, and it is advised that individuals withdrawing from cocaine and other stimulants seek either inpatient or outpatient treatment from a mental health professional trained in substance abuse to guide them through the detoxification and withdrawal process.
Symptoms of cocaine withdrawal (sometimes called a “crash”) can occur almost instantaneously when a person stops using the drug. Common side effects include, but are not limited to, the following:

Agitation and irritability
Restlessness
Depression and/or anxiety
Fatigue
Difficulty concentrating
Increased appetite
Vivid, unpleasant dreams
Suicidal thoughts

Cocaine is a stimulant drug, and stimulant withdrawal is different from withdrawal from other substances such as heroin and alcohol in that most of the symptoms are psychological and emotional as opposed to physical. For this reason, cocaine withdrawal is not considered life-threatening, although it is important to note that suicidal thoughts can occur in severe cases.
Drug cravings and emotional symptoms during cocaine withdrawal can be severe, and it is advised that individuals withdrawing from cocaine and other stimulants seek either inpatient or outpatient treatment from a mental health professional trained in substance abuse to guide them through the detoxification and withdrawal process.
Symptoms of cocaine withdrawal (sometimes called a “crash”) can occur almost instantaneously when a person stops using the drug. Common side effects include, but are not limited to, the following:

Agitation and irritability
Restlessness
Depression and/or anxiety
Fatigue
Difficulty concentrating
Increased appetite
Vivid, unpleasant dreams
Suicidal thoughts

Marijuana

Although marijuana is considered to be less addictive than other substances such as opioids and alcohol, studies have found that dependence on THC (tetrahydrocannabinol)—the active chemical in marijuana—is possible, and marijuana withdrawal syndrome can occur following sustained, heavy use of the drug. Marijuana withdrawal can be extremely unpleasant and even painful, and it is recommended that those suffering from marijuana addiction seek either inpatient or outpatient treatment from clinicians and mental health professionals.
In addition to intense drug cravings, common symptoms of marijuana withdrawal include, but are not limited to, the following:
Anxiety and depression
Headaches
Chills
Fever
Sweating
Fatigue
Irritability
Loss of appetite
Nausea and vomiting
Muscle cramps
Shakiness
Diarrhea
Insomnia
Stomach pain or discomfort

Addiction Treatment Options in Pennsylvania

Although marijuana is considered to be less addictive than other substances such as opioids and alcohol, studies have found that dependence on THC (tetrahydrocannabinol)—the active chemical in marijuana—is possible, and marijuana withdrawal syndrome can occur following sustained, heavy use of the drug. Marijuana withdrawal can be extremely unpleasant and even painful, and it is recommended that those suffering from marijuana addiction seek either inpatient or outpatient treatment from clinicians and mental health professionals.
In addition to intense drug cravings, common symptoms of marijuana withdrawal include, but are not limited to, the following:
Anxiety and depression
Headaches
Chills
Fever
Sweating
Fatigue
Irritability
Loss of appetite
Nausea and vomiting
Muscle cramps
Shakiness
Diarrhea
Insomnia
Stomach pain or discomfort

Residential/Inpatient treatment

Inpatient substance abuse treatment programs provide patients with a safe and secure setting in which to detox, recover, and begin to untangle the psychological and emotional components of their addictions. These programs are often recommended for withdrawal from substances like heroin and alcohol, which can be dangerous and even life-threatening to detox from.
Inpatient treatment centers are staffed 24/7 by trained medical and mental health professionals. A physician is always either on-site or on-call and patients are seen by a clinician on a regular, and sometimes daily, basis. Patients are also asked to participate in regular counseling and therapy sessions. This therapy can be in the form of individual or group therapy, and often includes both.
Inpatient treatment programs often last for 30 days. However, some patients benefit from longer stays. 60- and 90-day programs are offered by many inpatient treatment facilities, and some even offer 6-month programs for those recovering from severe addiction. Treatment professionals take a number of factors into consideration when determining the appropriate length of stay for a particular patient, including his or her history of addiction, the substance(s) abused, the severity of the physical and psychological addiction, past stays and relapses, familial history of drug or alcohol abuse, and any existing physical, mental, behavioral, or personality issues or diagnoses.
Inpatient treatment centers provide those suffering from drug and/or alcohol addiction with medical supervision and psychological and emotional support in a controlled environment away from work, family and friends, and free from drugs and alcohol. This allows patients to focus exclusively on detoxing, recovering, and getting well.

Outpatient treatment

Inpatient substance abuse treatment programs provide patients with a safe and secure setting in which to detox, recover, and begin to untangle the psychological and emotional components of their addictions. These programs are often recommended for withdrawal from substances like heroin and alcohol, which can be dangerous and even life-threatening to detox from.
Inpatient treatment centers are staffed 24/7 by trained medical and mental health professionals. A physician is always either on-site or on-call and patients are seen by a clinician on a regular, and sometimes daily, basis. Patients are also asked to participate in regular counseling and therapy sessions. This therapy can be in the form of individual or group therapy, and often includes both.
Inpatient treatment programs often last for 30 days. However, some patients benefit from longer stays. 60- and 90-day programs are offered by many inpatient treatment facilities, and some even offer 6-month programs for those recovering from severe addiction. Treatment professionals take a number of factors into consideration when determining the appropriate length of stay for a particular patient, including his or her history of addiction, the substance(s) abused, the severity of the physical and psychological addiction, past stays and relapses, familial history of drug or alcohol abuse, and any existing physical, mental, behavioral, or personality issues or diagnoses.
Inpatient treatment centers provide those suffering from drug and/or alcohol addiction with medical supervision and psychological and emotional support in a controlled environment away from work, family and friends, and free from drugs and alcohol. This allows patients to focus exclusively on detoxing, recovering, and getting well.

Intensive Outpatient Programs (OIPs)

Intensive outpatient programs (OIPs) are similar to outpatient programs, but require patients to spend more hours engaged in therapy and other treatment-related activities, and incorporate some components of traditional inpatient programs. OIPs usually require patients to spend upwards of 12 hours per week at the treatment facility—often up to 4 or 5 hours per day—and are often used to transition patients from inpatient treatment back into the community.
OIPs are also commonly used for patients who require more intensive treatment than outpatient programs provide, but whose conditions do not rise to the level of requiring inpatient treatment.

Aftercare

The process of transitioning from an inpatient, outpatient, or OIP treatment program to living independently can be a difficult one. Those who have undergone treatment, and particularly those making the transition out of an inpatient treatment program, have been continuously supervised and supported by professionals and peers during treatment. The hours, days, and weeks following treatment are critical to a recovering addict’s continued sobriety, and it is important for those exiting treatment to have a plan for ongoing sobriety and continued recovery.
Aftercare is an important part of making the transition out of treatment, and there are a number of resources available to those who are exiting treatment and returning back to everyday life and reentering the community. For many, maintaining a community of supportive individuals who are also committed to sobriety and recovery is extremely important. For others, ongoing individual or family therapy can help continue to address underlying psychological or emotional issues or past experiences that may have contributed to the development of the addiction.
Some of the most widely used resources are listed below:
Ongoing outpatient treatment and group therapy
Sober living houses
Pharmaceutical treatments
Individual therapy
Family counseling
Local or online support groups
12 step programs such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA)
Most people recovering from addiction find it helpful to develop a detailed plan for maintaining their sobriety, often referred to as aftercare. This is usually done, at least in part, during an inpatient or outpatient treatment program with the help of substance abuse treatment professionals.
Aftercare plans often include some combination of the following components:
A detailed relapse prevention strategy
Regular attendance at addiction support group meetings and/or group therapy
Residence in a controlled living environment (“halfway house,” sober living house, etc.)
Regular drug and alcohol tests
Regular check-ins with a sober coach, counselor, or clinician

Sober Living and Continuing Recovery

Although many treatment options—particularly inpatient and outpatient rehabilitation programs—have an end date, ongoing recovery and continuing sobriety is, for most who have suffered with addiction, a lifelong endeavor. Recovery does not end when an individual leaves a particular treatment program or facility. It is an ongoing process.
Recovering from addiction to drugs or alcohol and maintaining sobriety requires diligence, dedication, hard work, and self-acceptance. For most, there are difficult times and set-backs, but the rewards of maintaining sobriety and living a life free of dependency on drugs and alcohol are more than worth it. Over time, most people find that some days are more difficult than others, and there are a variety of ways to cope with those difficult times and stay on track.
Although there are a wide range of tried and true strategies for continuing recovery, just like treatment, ongoing recovery and sober living are individual processes. There is no “one-size-fits-all” approach to maintaining sobriety and living a healthy lifestyle.
Many people recovering from addiction to drugs and alcohol find that cultivating and maintaining a strong, supportive network of other people who have also suffered from addiction and are equally committed to sober living and recovery can be an extremely important component of staying on track. As previously discussed, there are many organized aftercare and support-group options for those who wish to make connections with peers. Many people also remain in contact with friends they may have connected with during inpatient or outpatient treatment. For most, it is helpful to have some kind of community of reliable and supportive people to reach out to in difficult or especially trying times.
For many, particularly those recovering from severe and long-term addictions to highly addictive substances, sober living homes can provide security and community, and help ensure a smooth transition from traditional treatment programs back to everyday life. Sober living homes have proven to be an especially helpful option for those recovering from heroin and other opioid addictions. Learn more about how sober living homes work here.
Although sober living homes and other formal options can be extremely helpful and effective for many recovering from addiction to drugs and alcohol, not everyone prefers a formal approach to aftercare. Each individual finds their own path to recovery, often with the help and company of family, friends, loved ones, and peers.

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