Thursday, February 21, 2019

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Drug Addiction Treatment in Knoxville, Tennessee

Knoxville is the third largest city in Tennessee after Nashville and Memphis, with a recorded population of roughly 185,000. Knoxville is a major economic and industrial hub and the primary city in the Knoxville Metropolitan Statistical Area. Despite its long and rich history, Knoxville has struggled economically since the demise of its manufacturing and textile industries in the 1960s. Several recent projects have attempted to increase revenue in the downtown part of the city, including the Women’s Basketball Hall of Fame, the Knoxville Convention Center, and the rebuilding of Market Square. Like many cities in Tennessee, Knoxville is struggling with a number of substance-related disorders, with illegal and prescription drug abuse adversely affecting the city through increased healthcare costs, rising crime rates, and overdose deaths. If you know anyone in Knoxville or Tennessee who is currently living with a substance abuse problem, it’s important to find professional help as soon as you can. 

Demographics and Crime in Knoxville

Knoxville residents live in a number of neighborhoods and unincorporated communities, including Halls Crossroads, Sequoyah Hills, West Hills, Bearden, Powell, Karns, Corryton and Mascot among others. Knoxville is quite a young city with an average age of just 32.7 recorded in the latest census, with almost 20 percent of residents being under the age of 18. The racial profile of Knoxville is not particularly diverse, being 76.1 percent White, 17.1 percent African American, and 4.6 percent Latino or Hispanic. Knoxville residents face a lot of poverty, with the median income in the city just $32,609 for households and $21,528 for individuals. This means that one quarter of all Knoxville residents are living below the poverty line, a massive number that is much bigger than the Tennessee average of 16 percent and the national average of 15 percent. Poverty rates are often linked with substance abuse and addiction, with people from low income areas also facing problems with treatment access and affordability.

In terms of crime, Knoxville has an index of 2 according to Neighborhood Scout, meaning it is safer than just 2 percent of American cities. The overall crime rate in Knoxville is 66.21 per 1,000 residents, with the violent crime rate being 9.02 and the property crime rate being 57.19 per 1,000 residents. These numbers are also much higher than the state and national averages, which are 6.33 and 4.00 for violent crimes and 28.54 and 25.00 for property crimes respectively. Property crimes are often linked to substance abuse and addiction, with people stealing from homes, cars, and businesses in order to make money to purchase drugs. A number of violent crimes in Knoxville have also been linked to the city’s drug problems, especially those that are related to gang activity and drug trafficking. 

Common Drug Problems in Knoxville and Tennessee

People from Knoxville and the state of Tennessee face a range of drug problems, including the legal drug alcohol, a variety of prescription medications, and illega drugs such as heroin and methamphetamine. Knoxville and the Appalachian region community is at the center of the opioid crisis faced by many American cities. 118 people died of a drug overdose in Knox County during the first six months of 2016 alone, with a massive 1600 percent increase in heroin-related incidents recorded over the past five years according to the Knoxville police department. Knox County experienced a huge 31 percent increase in deaths caused by opioid drugs in 2016, a number much higher than the Tennessee or national averages. In a worrying statistic, more than a tenth of these deaths involved the powerful prescription opioid drug fentanyl.

Prescription opioid problems and heroin abuse are often correlated, with opioid addicts gravitating to heroin after becoming dependent on prescription drugs and street drugs like heroin mixed with prescription drugs to increase profits and provide a more potent effect. The problem has become so bad that police officers in Knoxville are expected to carry the opioid antidote Naloxone in case they need to administer it in the field to people who have overdosed. While prescription opioids and heroin are the biggest problems in Knoxville and the state of Tennessee, police and drug treatment clinicians also face ongoing problems related to cocaine abuse, methamphetamine abuse, and alcoholism.

Signs and Symptoms of Drug Abuse

Substance abuse, also known as drug abuse, affects people from all walks of life. From legal drugs like alcohol and nicotine through to prescription medications and street drugs, substance abuse exacts a high toll on modern American society. People often go to extreme lengths to hide their drug abuse from friends and family members, which can make is hard to identify problems. There are some general warning signs to look out for, however, with specific symptoms dependent on the actual compound being abused. If you’re worried about problematic substance abuse by someone you know and love, it’s important to find professional help as soon as you can. Signs of drug abuse include: 

  • Unexplained social problems
  • Unexplained health problems
  • Unexplained financial problems
  • Mood swings
  • Anxiety and/or depression
  • Altered sleeping patterns
  • Altered eating patterns
  • Changes in social groups
  • Tolerance and withdrawal symptoms
  • Work and/or school problems

What is Addiction?

Addiction involves the patterned and compulsive engagement in rewarding stimuli despite the existence of adverse consequences. People can become addicted to a wide range of stimuli, including psychoactive substance and behaviors. Common substance addictions include prescription opioids, heroin, cocaine, methamphetamine, marijuana and many others. Common behavioral addictions include sex addiction, gambling addiction, food addiction, Internet addiction and many others. Addictive stimuli need to be both reinforcing and rewarding, with people engaging with problematic substances again and again in order to reinforce particular neural pathways.

While addiction is a close relative of dependence, it’s important to understand the difference between these two concepts. Physical or psychological drug dependence is recognized by the existence of withdrawal symptoms when drug use is stopped. It is not necessarily associated with compulsive or uncontrolled drug use patterns. For example, someone can develop a dependence to their medication without becoming addicted to it. Addiction is a brain disorder that normally develops over time in response to repeated drug exposure. While some people can become addicted to certain substances quickly, most people go through an experimental phase of drug use before drug abuse develops into possible dependence and addiction. In order to treat addiction effectively, patients need to go through specialized drug rehabilitation.  

Assessment and Pre-Intake

Before embarking on a treatment regime, patients need to be assessed both physically and mentally. Doctors and clinicians need to analyze each case on its own merits and carry out a detailed risk assessment before they can administer any medications or psychotherapeutic treatments. Possible factors that can influence the treatment process include mental health disorders, co-occurring disorders, behavioral addictions, extent of drug abuse, history of drug abuse, substance of abuse, and external factors likely to impede the treatment process. People who have co-existing mental health or behavioral addictions may be directed towards specialized treatment clinics who deal with dual diagnosis patients. 

During assessment, clinicians will also look at any lifestyle or criminal justice issues that may affect treatment or treatment access. For example, people with dependent children to look after may not be able to enroll in full-time residential rehab. Things like homelessness and domestic violence can also impede treatment, with each case needing to be analyzed carefully and dealt with on its own merits. Perhaps the most important factor that clinicians need to consider during the intake procedure is the existence or potential existence of a physical-somatic withdrawal syndrome. Alcoholics, opioid addicts, and people who abuse sedative medications are likely to experience dangerous and potentially deadly physical symptoms unless they have access to appropriate medication. This needs to be addressed at the outset to ensure safe and effective treatment. 

How can I find an addiction rehab program?

Detox

Detoxification is the process and experience of drug or alcohol withdrawal in a safe and supervised setting. Detox is designed to enable drug discontinuation and stabilize patients prior to rehab. It’s important to reduce the severity of dangerous withdrawal symptoms before they create additional complications, with medications often used to this effect. While not all substances are capable of causing a physical-somatic withdrawal syndrome, those that do need to be addressed quickly and with constant supervision. Drugs known to cause physical dependence and withdrawal include alcohol, codeine, morphine, hydrocodone, oxycodone, fentanyl, heroin, Valium, Xanax, Klonopin, and a range of other prescription opioids, barbiturates, and benzodiazepines.

 

Common physical symptoms addressed during detox include headaches, nausea, vomiting, abdominal cramps, aches and pains, fever, seizures, hallucinations, and delirium tremens. While some of these symptoms are mild and short acting, others are severe and can lead to serious consequences such as brain damage and death. While it is possible to stabilize patients without the use of medications, rapid detox and “cold turkey” programs can be dangerous for many patients. Before embarking on detox treatment, it’s important to be assessed by a specialized drug treatment doctor or clinician. 

 

What is withdrawal? How long does it last?

Medical Detox Stages

According to the National Institute on Drug Abuse (NIDA), there are three separate stages in every detox process.

The first stage is known as evaluation, with the patient tested physically and mentally before starting a medication regime. Physical blood tests are often carried out during this stage to test for currently circulating substances, with central nervous system (CNS) depressants particularly dangerous.

The second stage of detox is known as stabilization, with medications typically administered during this phase of treatment. While the medications used vary according to the substance of abuse, CNS depressants such as Valium, methadone, and buprenorphine may be prescribed to help reduce withdrawal symptoms and encourage abstinence. If blood tests are not carried out to identify existing substances, patients may overdose or experience other medical complications.

The third and final stage of detox attempts to guide patients into further treatment. It’s important to understand the limitations of medical detox, which is only designed to manage the withdrawal process itself. Detox does nothing to identify or solve the psychological problems that have created addiction in the first place.

Psychotherapy is also needed to promote long-term abstinence and recovery in the weeks, months, and years that follow detox. Detox clinics use different methods to help people understand the importance of ongoing treatment, with the friends and family of addicts often brought in to provide support and encouragement.

Rehabilitation

Drug rehabilitation is the process of treatment for substances of abuse and dependency. Drug rehab can include both medication therapy and psychotherapy programs, both of which attempt to promote long-term recovery and other positive outcomes. Drug rehab clinics are available in Tennessee and across the United States, from informal treatment sessions through to immersive and full-time residential programs. While detox is designed primarily to address the physical-somatic withdrawal symptoms associated with physical drug dependence, rehab is designed to address the issues that surround psychological dependency.

Rehab is an important part of drug treatment and should always follow detox in order to support long-term treatment outcomes. Rehab is available on an inpatient or outpatient basis, with patients choosing treatment based on their needs and financial constraints. 

Pharmacotherapy

Also known as medication therapy, pharmacotherapy programs involve the administration of certain medications in the context of harm reduction and lifestyle management. While medication therapy does not necessarily address the underlying currents of drug addiction, it can prove incredibly useful when combined with psychotherapy programs. Opioid addicts often receive medications during and after rehab to help them reduce cravings, including alternative opioid drugs like methadone and buprenorphine. This practice, known as opiate replacement therapy, has been shown to reduce many of the risks associated with drug use such as crime, overdose, and disease. Medications may also be applied for other substance use disorders, especially those that are known to cause physical dependence. For example, alcoholics and Valium addicts may be given benzodiazepine medications to help them reduce cravings. Acamprosate and disulfiram are also available from some treatment centers for long-term and treatment resistant alcoholics.

Psychotherapy

Despite the widespread use of medications during rehabilitation, most rehab programs are based on psychotherapy treatments. Common treatment paradigms applied during rehab include cognitive therapy, motivational therapy, behavioral therapy, family therapy, 12-step facilitation, client-centered counseling, group counseling, art therapy, moral recognition therapy and many others. While medication programs help clinicians to manage drug addiction, psychotherapy programs attempt to deal with the emotional and social factors that created addiction in the first place. While there are many ways to do this, most treatment systems will attempt to analyze the emotional, environmental, and cognitive distortions that influence negative behavior patterns. Once people are able to recognize their problems, therapists help them to learn new coping skills and develop positive psychological associations. Psychotherapy sessions can be conducted in many environments, from informal treatment sessions through to full-time residential programs.  

Inpatient vs. Outpatient Treatment

More on Inpatient vs. Outpatient

Before starting a drug rehab program, it’s important to understand the difference between inpatient and outpatient rehab. Also known as residential rehab, inpatient programs operate on a full-time basis and provide accommodation facilities. While this can be expensive, residential rehab provides the most comprehensive level of coverage for people in need. Inpatient programs are often recommended for people with physical drug dependencies, those with a long history of drug addiction, and anyone who wants to avoid relapse by removing themselves from their home environment. Residential treatment centers (RTC) provide full-time rehab, partial hospitalization (PHP) programs provide full-time treatment on week days only, and intensive outpatient programs (IOP) provide full-time 9-5 treatment with no accommodation facilities. All of these options may provide access to medication therapy and psychotherapy, with typical programs lasting anywhere from a couple of weeks to six months.

Outpatient rehab differs in many ways from inpatient programs, with patients living at home for the duration of treatment while attending periodic treatment sessions. There are lots of different flavors of outpatient rehab available in Tennessee, from single group meetings and 12-step support groups through to multi-week programs. While outpatient rehabilitation is less likely to provide opiate replacement therapy and other forms of pharmacotherapy, ongoing medication services are available in many American states. Outpatient rehab is typically based on conventional 12-step and counseling approaches, including group counseling and motivational support programs.   

Should I choose inpatient or outpatient?

Relapse Prevention

Relapse prevention is an integral aspect of drug rehabilitation, both during formal rehab programs and on an aftercare basis. According to NIDA, roughly 50 percent of all drug addiction treatment patients relapse at some point, either straight away or after they have been sober for an extended period. In order to reduce this figure and give people the skills they need to support long-term recovery, dedicated relapse prevention programs need to be applied. Most relapse prevention systems are based on cognitive behavioral therapy, with practitioners helping patients to identify potential triggers, avoid risky situations, and cope with the challenges of life as they arise. Relapse generally takes place in three separate stages, with clinicians able to help people recognize the warning signs before its too late. 

During the early stages of emotional relapse, people will often feel confused and anxious about the recovery process. They may be struggling with negative emotions but not have the skills to identify them properly or do anything about them. Anger, resentment, and frustration are common during this stage, with unhelpful emotions often leading to impulsive and compulsive responses if not dealt with properly. Emotional relapse will transform into mental relapse easily  without treatment, with people now starting to plan specific relapse events and fantasize about returning to drug use. While all of this can be easily identified by trained counselors, recovering addicts may be unable to put the pieces together until it’s too late. Trigger recognition strategies also play a crucial role, with common triggers including negative emotions, social proximity, and location proximity.

Aftercare

Aftercare is essential in any addiction management plan. While detox helps people to stop using drugs in a safe and supportive environment and rehab helps them to address the undercurrents of addiction, both of these measures are not enough by themselves. Also known as ongoing care or continuing care, aftercare promotes long-term abstinence and recovery in the weeks, months, and years that follow drug discontinuation. Common aftercare programs include 12-step support groups, SMART Recovery, family therapy, counseling, and practical support systems.

Sober living environments (SLEs) offer a special kind of aftercare support to people as they transition from treatment back to everyday life. Also known as sober living houses or sober living homes, these programs provide people with affordable accommodation and ongoing psychotherapeutic support. Most SLEs operate under a strict set of rules and guidelines, with common rule structures including no drug or alcohol consumption, random drug and alcohol testing, no overnight guests, respect given to staff and house guests, and participation in rehab programs. If you know anyone in Knoxville who is living with a substance use disorder, it’s important to access professional treatment as soon as you can. 

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