Addiction and Drug Abuse Treatment in Erie, Pennsylvania
Over the last two decades, communities across the United States have suffered from overwhelming increases in drug abuse and addiction rates. Nationwide, this crisis has caused the suffering of countless individuals and families from diverse backgrounds and circumstances. In 2016, over 63,600 Americans died as a result of a drug overdose. Opioids account for the majority of these deaths. Prescription or synthetic opioids were involved in 66 percent of these fatalities nationwide. Every state and city across the country has been impacted by this epidemic; however, the drug crisis presents itself differently in different regions.
Erie is a small city with a population of 100,621 residents, located in the northernmost part of the state, on Lake Erie in the Commonwealth of Pennsylvania. In 2017, Erie County experienced the highest number of drug overdoses it has seen in its history. This epidemic does not discriminate. According to county officials, victims from a variety of educational, socioeconomic, and ethnic and racial backgrounds are represented, and victims are young and old, male and female.
Synthetic opioids are the primary cause of death in Erie County drug overdoses, and across the entire state. In a report involving data compiled by the Centers of Disease Control and Prevention (CDC), the Commonwealth of Pennsylvania joined West Virginia, Ohio, New Hampshire, and Kentucky as one of the states with the most serious problems with addiction and drug abuse. The widespread use of both prescription and synthetic opioids has emerged over the last decade as the primary drug-related concern of government officials and law enforcement in the state.
A report published jointly by the DEA Philadelphia Division and researchers at the University of Pittsburgh recently revealed that, in 2016, approximately 85 percent of drug overdoses in Pennsylvania involved opioids in prescription or illicit form. Fentanyl or related substances were identified in 52 percent of these cases, while heroin was identified in 45 percent. Opioid medications that require a prescription from a physician were found in 25 percent of drug-related deaths.
The opioid epidemic, which has affected nearly every community across the Commonwealth and across the entire nation, began to emerge in the 1990s, when pharmaceutical companies assured doctors and other medical professionals that opioid pain relievers were non-addictive. This led to an increase in doctors prescribing these medications to patients following surgeries or for chronic or acute pain symptoms. Many patients developed a dependency on prescription opioids—which are, in reality, highly addictive—before they or their physician were aware that a problem existed. Since the 1990s, rates of opioid abuse, addiction, and overdose have steadily risen.
If you or a loved one is struggling with an addiction to opioids or other substance(s), you are not alone. You do not have to suffer in silence. Rehabilitation and substance abuse treatment has been shown to be effective in treating even the most severe addictions. Keep reading to learn about the symptoms of opioid addiction and how treatment works.
Signs and Symptoms of Opioid Abuse and Addiction
Opioid addiction is a cruel and unyielding disease characterized by repeated, compulsive abuse of synthetic or prescription opioids despite physical, social, behavioral, and/or psychological consequences. This disease impairs important functions in the brain in a variety of ways, and can cause physical, behavioral, and psychological symptoms.
If you have never experienced addiction before, it may be difficult to detect the symptoms of opioid abuse and dependency in a loved one, or even in yourself. However, there are some signs and symptoms to look for, including the following:
- Warm, red, or itchy skin
- Respiratory problems, including slowed or heavy breathing
- Dehydration or dry mouth
- Constricted Pupils
- Decreased personal hygiene
- Changes in eating patterns or weight
- Changes in sleeping patterns
- Drowsiness, sedation, or lack of energy
- Over- or under-activity
- Increased irritability, agitation, or other mood changes
- Decreased interest in social activities
- Depression or anxiety
- Confusion, delusions, paranoia, or hallucinations
Not everyone suffering from opioid abuse and dependency will experience or exhibit the above signs and symptoms. This list simply represents symptoms commonly experienced by those suffering from opioid addiction, noticed by their loved ones, and/or observed by a medical professional.
The thought of undergoing treatment for opioid addiction or addiction to other substances often produces anxiety, fear, resentment, or even anger from those struggling with the disease. These feelings are entirely normal, and often result in part from the chemical and functional changes that result from substance addiction. With the right strategies and methods, treatment is effective.
There are a variety of rehabilitation programs and resources available to those suffering from opioid addiction and dependency to other substances in Erie, across the Commonwealth, and elsewhere. Keep reading to learn about the recovery process and what to expect from rehabilitation.
The Treatment Process
Prior to entering addiction rehabilitation, most people feel some anxiety and have questions about what the intake, detox, and treatment process will be like. Learning as much as possible about the rehabilitation process in general, and the particular treatment methods, procedures, and expectations of any particular facility you consider attending can help ease many of these concerns.
Many rehabilitation centers have some basic information and frequently asked questions listed on their websites, and it is a good idea to do some research prior to deciding on any particular program. If you know anyone who may have undergone treatment before, it can also be helpful to ask them about their experiences if you feel comfortable doing so.
In addition to concerns about what to expect from treatment, it is common for people to worry about practical matters, and how they will take time away from their everyday lives in order to attend treatment. Some common concerns many people face prior to entering rehabilitation including the following:
- How children, elderly or disabled relatives, pets, or other dependents will be cared for
- How bills will be paid (there are automatic payment systems you can sign up for, or you may choose to enlist the help of a friend or family member)
- How to inform an employer or school officials about a temporary absence (all employees in the United States are entitled to 12 weeks of medical leave under the Family and Medical Leave Act (FMLA), which may be used for addiction treatment)
- How to pay for treatment (typically, insurance will cover most or all treatment costs)
- How to prepare for discharge and avoid relapse after treatment
Family, friends, or other loved ones may be able to help you with many of the above concerns. Having these and any other practical matters and responsibilities taken care of prior to entering treatment can help you focus on rehabilitation and getting well.
Assessment and Intake
Although the assessment and intake process differs substantially from facility to facility, there are some standardized processes and procedures you are likely to encounter upon your arrival for addiction rehabilitation.
Typically, when a new patient arrives for treatment, a thorough drug assessment is carried out. These assessments allow staff members, including addiction specialists, therapists, and medical professionals, to gain an understanding of the patient’s substance use patterns, their level of physical and psychological addiction, and their overall health. Although the particular methods of assessment differ, most facilities incorporate some combination of the following:
- A breathalyzer and/or blood and urine samples
- A comprehensive physical exam
- Going over medical records and family health history
- A one-on-one meeting between the patient and an addiction counselor or psychiatrist
- Self-reported surveys measuring substance use patterns, attitudes and beliefs about addiction, and overall mental health
Unfortunately, patients often feel shame or anxiety about their mental health and past or present substance abuse habits. Some of the questions you may be asked during the assessment process may feel uncomfortable or embarrassing to answer. It is vitally important to be as honest as possible with staff members during the intake process and going forward, so that they can help you recover and provide individualized and appropriate care and therapy.
During the intake process, patients are also typically informed about any rules, regulations, policies or expectations. There are often rules about visiting hours, when patients can make calls, and required attendance at certain counseling sessions or appointments. During intake, you will likely be asked to sign various consent forms. Additionally, a staff member will generally go through your bags with you to remove any restricted items you may have brought with you. Restricted items vary from center to center; however, drugs, alcohol, unapproved medications, weapons, and otherwise dangerous objects or substances are almost always restricted.
The last component of intake generally involves a tour of the facility, a chance to unpack your things and meet other patients, and a warm meal. You may also be invited to attend a therapy session, although this is often optional on the first day of treatment.
Not every patient undergoing treatment for addiction has to go through detox; however, most people who suffer from an addiction to synthetic or prescription opioids, cocaine, methamphetamines or crystal meth, benzodiazepines, alcohol, and other highly addictive substances have to go through a detoxification and withdrawal process. Detox is typically one of the first components of addiction treatment, and it is a process that many people worry about prior to entering rehabilitation.
As previously discussed, repeated use of addictive substances can fundamentally rewire the brain of the user. Most patients suffer from a combination of physical and psychological addiction. Addiction causes the brain and body to become dependent upon receiving their usual dose of drugs or alcohol, and when a patient stops using the substance, the brain responds. “Detox” refers to the process during which a patient’s body rids itself of the toxins and chemicals associated with the drug and the addiction. Often, this process produces a variety of side effects.
Common symptoms of drug and alcohol withdrawal include the following:
- Intense drug cravings
- Nausea and vomiting
- Loss of appetite
- Muscle spasms and body aches
- Stomach cramps
- Dehydration, sweating, and dry mouth
- Fatigue, drowsiness, and insomnia
- Difficulty concentrating
- Anxiety, depression, irritability, and other mood changes
Each individual patient experiences detox and withdrawal differently, and not every patient will experience any or all of the above symptoms. Symptoms of withdrawal depend on a variety of factors, including the substance to which a person is addicted, their level of physical and psychological dependency, the duration of their addiction, and their individual biology and genetic makeup.
In most cases, the severity of withdrawal symptoms peaks between 24 and 48 hours of the last dose of the addictive substance; however, there is great deal of individual variance in terms of how long withdrawal may last. In most cases, those detoxing from synthetic or prescription opioids (and/or other drugs that may be very unpleasant or even dangerous to withdraw from) are advised to be medically monitored during detoxification.
Although the detox and withdrawal process is an important component of rehabilitation, in the vast majority of cases additional treatment and therapy is needed to lead to long-term sobriety and continued recovery. Keep reading to learn about some of the types of inpatient and outpatient treatment and what to expect with each type.
Inpatient rehabilitation allows patients recovering from substance abuse and addiction to undergo treatment in a safe and entirely drug-free environment. In residential/inpatient treatment programs, patients live full-time at the rehabilitation facility and typically do not leave the center unless there is a scheduled, supervised outing.
Residential and inpatient rehabilitation programs are generally the most intensive, as they provide recovering individuals with medical and mental health monitoring, peer support, rigorous and comprehensive individual and group therapy, and other support on a full-time, round-the-clock basis. This type of treatment also allows those who require a detox and withdrawal period to be medically monitored during this process.
Although inpatient rehabilitation programs differ substantially, and utilize a variety of different treatment methods and strategies, intensive, residential/inpatient treatment can be separated broadly into two categories:
- Short-term inpatient programs – Patients live full-time at the rehabilitation facility for up to 30 days, abstaining from drugs and alcohol, detoxing and withdrawing, and participating in individual and group therapy, relapse-avoidance training, and educational programs.
- Long-term inpatient programs – Patients live full-time at the rehabilitation facility for longer than 30 days—and may remain living there for several months to up to a year—abstaining from drugs and alcohol, undergoing detox and withdrawal, and receiving professional and peer support, medical supervision, intensive individual and group therapy, coping and relapse-avoidance strategies, and education.
Inpatient rehabilitation is typically more intensive and higher cost than outpatient treatment. The additional professional supervision and round-the-clock support offered at residential treatment allows individuals suffering from even the most severe addictions to detox and recover in a safe and drug-free environment. Therefore, inpatient treatment is often recommended for those recovering from opioid addiction.
As is the case with any type of drug addiction treatment, it is important to make sure that any particular inpatient facility you consider attending meets your individual needs and preferences and addresses your individual concerns.
Outpatient or non-residential treatment differs from inpatient rehabilitation in that patients do not live at the treatment center on a full-time basis. Instead, patients undergoing outpatient rehabilitation are typically required to be at the treatment facility during certain hours of the day or week, but live at home with friends or family, or at a transitional sober living home (sometimes referred to as a “halfway house”).
Since outpatient treatment cannot provide the same kind of 24-hour supervision and support offered at inpatient rehabilitation facilities, those undergoing outpatient rehabilitation are typically required to attend regular physical and mental health check-ups and submit to periodic drug tests, which may include a blood or urine sample and/or a breathalyzer.
Outpatient rehabilitation is typically less intensive (and lower cost) than inpatient treatment; therefore, these kinds of programs tend to last longer. Although less intensive on average, outpatient treatment programs often incorporate many of the same components of inpatient rehabilitation. Although, like inpatient programs, outpatient treatment differs substantially from program to program, and there are a wide variety of outpatient treatment types. Almost every addiction treatment incorporates counseling and therapy.
More intensive forms of outpatient rehabilitation include the following:
- Intensive Outpatient Programs (IOP) – Patients spend several hours at the treatment facility at least three days per week, receiving intensive group and individual therapy, medical and mental health monitoring and treatment, medication management, abstaining from drugs and alcohol, and participating in peer support groups, educational programs, and learning relapse-avoidance strategies and coping techniques.
- Partial Hospitalization Programs (PHP) – Patients in partial hospitalization programs typically spend several hours at the treatment facility every day, receiving intensive individual and group therapy, medication management, individualized case management, close medical and mental health monitoring, and relapse-avoidance training. Sometimes referred to as “day rehab,” this kind of treatment is well-suited to patients who require substantial medical supervision.
Although inpatient treatment is often recommended to those with severe addictions and those who suffer from opioid addiction, due to the additional risks associated with detox, outpatient treatment may be the right option for those with less severe addictions, those who do not require a detox period, or those who are unable to commit to inpatient rehabilitation. Outpatient treatment is often also recommended to patients who have recently been discharged from inpatient rehabilitation, who may require ongoing supervision and support.
Aftercare and Sober Living
One of the most important moments of the entire rehabilitation process is the moment when a patient leaves treatment. Up until discharge, patients are supervised by medical professionals and addiction specialists and supported by a community of peers. Additionally, in the case of inpatient treatment, patients remain in an entirely drug-free environment while they recover. The hours, days, weeks, and months following discharge from an organized treatment facility are of the utmost importance for the long-term success of treatment and a patient’s continued recovery and sobriety.
Patients who have just exited treatment are at increased risk of relapse, and those recovering from opioid addiction are at increased risk of overdose in the case of a relapse. Detox and withdrawal, therapy, and medical supervision are all important components of addiction rehabilitation. Aftercare is equally important.
“Aftercare” is a broad term used to describe any form of continued treatment a patient receives or participates in following an inpatient rehabilitation stay or outpatient treatment. A patient’s use of aftercare resources has been shown to contribute to their long-term sobriety.
Some of the most commonly utilized aftercare resources include the following:
- Continued outpatient treatment, including intensive outpatient programs (IOP) and partial hospitalization programs (PHP)
- Living at a sober living home
- Continued individual, group, couples, or family counseling
- Local or online support groups
- Cognitive behavioral therapy (CBT)
- Educational programs
- 12 step programs, such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA)
Recovery does not end upon discharge. It is an ongoing and often lifelong process, and many recovering individuals find that some form of aftercare helps them stay on track and maintain a supportive network of people who understand what it means to suffer from addiction, undergo treatment, and dedicate oneself to continued sobriety.