Vermont Addiction and Treatment
Vermont is the second smallest state in the United States with approximately 624,594 people and is located in the New England region. The state is not particularly diverse as 94.1% of the population is white according to 2015 statistics. The rest of the population is unevenly divided to 3% Asian, 2.5% black, 2.3% Hispanic and 0.4% Native American. The state has a 6.2% unemployment rate that is the fourth lowest in the US. The median household income is $49,949 and is the 25th highest of all 50 states. According to a state-wide religious survey in 2014, the highest percent of the population 37%, do not associate themselves with any religion. The most frequent religious group in the state are Protestants but barely make up the majority of the population at 30%. 22% of the population considers themselves Catholic, which is the next most common religion. Of the rest of the population 1% considers themselves to be Eastern Orthodox, 2% are Jewish, 1% are Hindu and 1% are Buddhist.
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Wisconsin and the Opioid Epidemic
Wisconsin’s drug abuse epidemic reflects a growing trend throughout the United States. More and more people dying due to overdose than ever before. The National Survey on Drug Use and Health estimates that there are nearly half a million untreated active heroin users in the United States. The rate of heroin addicts entering rehab and being admitted to emergency rooms has grown steadily in that period which has led many to proclaim that there is an opioid epidemic.
Indeed, the aggressive prescription of opioid-based painkillers and drugs like fentanyl which can now be made on the street has led to a growing scare that those in government and hospitals are ill-equipped to deal with.
All of this leads to a growing picture of a culture of addiction. From 2001 to 2007, the number of deaths attributed to heroin overdoses in Wisconsin remained roughly consistent at around 27 per year. But by 2014, that number had skyrocketed to 267 per year just in Wisconsin alone. This is despite the fact that drugs like naloxone are now routinely distributed to emergency medical personnel and can successfully prevent overdoses.
75% of that number were males. 80% were white. Only 33% had a high school diploma. Nearly half of those who died heroin overdoses lived in either Milwaukee and Dane County.
Why Heroin Abuse is on the Rise
There’s no shortage of blame to go around for who is at fault for the opioid epidemic. Many have rightfully criticized doctors and drug companies for the over-prescribing and deceptive marketing of opioid-based pain management medications. Others have noted the heroin that has found its way into the Wisconsin market is purer and does not need to be injected. Law enforcement has remarked that the distribution of heroin has grown more advanced and easier to accomplish and this has resulted in lower prices and easier access to the drug.
The key component, however, seems to the rise in abuse of prescription opioids that are marketed for pain management. Of the 834 drug overdose deaths in 2014, 382 (45%) were due to prescription opioids such as oxycontin, methadone, hydrocodone, and others, while heroin only accounted for 27%. Of that 27%, it’s impossible to say how many got their start from abusing pain medication that they were prescribed by a doctor.
Statistically speaking, the so-called opioid epidemic began around about the same time doctors and drug companies began using opioids more frequently to treat pain. While some of this has to do with the fact there aren’t enough doctors in the US that specialize in pain management, a lot boils down to the mismanaging of the medication by both doctors and their patients. Opioids have high rates of abuse and even for those whom drug abuse was not alluring or romanticized can easily find themselves in the grips of opioid addiction through no fault of their own.
It was also around this same period when a black market for prescription pain medications blossomed. Mules would go shopping for doctors who they believed would be easy marks for prescriptions. They would fake symptoms, purchase the medication, and then sell it on the street for major profits.
The pharmaceutical companies were happy because they were seeing record profits, which was exactly what they had hoped for. They were actively promoting the drugs to doctors who then prescribed them to patients that were more than willing to take them. When complications arose, the doctors might cut off the prescription, but the patient was left going through a horrible withdrawal syndrome. In other cases, the addiction would go unchecked. A number of these people were older Americans who suffered from common ailments such as arthritis. Others were middle-aged folks that were coming out of recent surgeries.
This has resulted in New York City filing a half a billion dollar lawsuit against drug companies over the opioid deaths. While heroin and other opioids were a problem in the early 2000’s and the 1990’s, the statistics were nowhere near as grim as they are in 2018. According to one report, more than 1 in 3 Americans was prescribed opioids in 2015.
Part of the issue is that insurance companies are very quick to cover opioid prescriptions for pain in the US, whereas in other countries, they’re much more reluctant. This has led to a situation in which the US is responsible for nearly 27% of the world’s drug overdoses, despite having only 4% of the population. In 2015, roughly 6,800 Europeans died of opioid-related overdoses. The number in the US was over 30,000. This is despite the fact that Europe’s population exceeds that of the US’s.
While prescription opioids, reckless doctors, and aggressive pharmaceutical companies are a huge part of the problem, another one is the availability of street-grade heroin and fentanyl. Another part of the issue is Milwaukee. Milwaukee, as the 7th largest city in the US, is well known as a key center of distribution for legitimate goods. But its location also serves to benefit drug traffickers the same way. Milwaukee sits on Lake Michigan and has one of the largest ports there. Among the cargo passed through that port is illegal drugs. Cartels have also become smarter about how they move and traffic these drugs. They can be made cheaply, moved efficiently, and this has lowered prices across the board.
Regardless of the cause, the heroin and opioid problem in the United States continues to get worse by the month. Law enforcement is overwhelmed and ill-equipped to deal with the growing crisis. Medical facilities are overwhelmed by the growing need for effective measures. Americans are more at risk each year.
What is an Opioid?
While there used to be a distinction between the terms “opiate” and “opioid”, the term “opioid” variously refers to a class of synthetically derived opiate derivatives, or any drug that activates opioid receptors in the brain. Opiates, on the other hand, only refer to naturally derived drugs like opium. This distinction isn’t overly important. The word “opioid” is generically used to describe the entire family of drugs that act on and bind to opioid receptors in the brain.
There are four classes of opioids:
1. Opioids that naturally occur in the body, also called endogenous opioids. Example: endorphins.
2. Opium alkaloids that are derived from opium, once known as opiates. Example: morphine and codeine.
3. Semi-synthetic opioids have similar structures to opium alkaloids. Example: heroin and oxycodone.
4. Fully synthetic opioids have structures unrelated to opium alkaloids. Example: methadone.
Clinically speaking, when these drugs bond to opioid receptors in the brain, they send a signal to slow breathing, reduce pain, and give a calming and tranquil effect. They also produce a temporary euphoria. For those that suffer from acute or chronic pain, these drugs can be effective at reducing that pain. In certain instances, the body can’t produce enough natural opioids itself to reduce pain.
In addition, opioid receptors are involved in the reward system of the brain. When an individual accomplishes something major, a new relationship, winning a competitive event, achievement of a lifelong goal, or a major professional success, the brain naturally produces chemicals that are involved in the sensation of joy and pleasure. Opioids can artificially stimulate this sensation.
Opioids’ effect as a respiratory depressant is what causes an overdose. Eventually, breathing is slowed to the point of stopping altogether.
What is Heroin?
Heroin is a synthetic opioid derived from morphine. Its clinical name is diamorphine. It comes in two general different kinds. Those are black tar, which is mostly produced in Mexico, and a white or brown powder that generally comes from Asia. Of the two, the powdered form is the purest. Black tar heroin is so named because it’s a claylike block that is riddled with numerous impurities. It generally needs to be injected in order to have the full effect. Powdered heroin, being far more pure, can be smoked, snorted, injected, or mixed with tea.
It was first synthesized in the late 1800’s by an English chemist, and then later produced by the Bayer corporation as an all-purpose medication. As doctors became aware of the addictive effects of drugs like morphine, an alternative was sought to produce the same effects without the addictive properties. Ironically, heroin was a product of that effort.
At the time, it was considered a miracle drug and used to treat all manner of maladies ranging from common colds to mental illness. It was given to women to treat premenstrual syndrome. Today, there is no known clinical benefit of using the drug.
One of the reasons why heroin is among the most addictive substances known to man is that the drug naturally hones the euphoric properties of the opioid class. This results in the high that users feel directly after abusing the drug.
What is Fentanyl?
Fentanyl is also a synthetic opioid. Unlike heroin, it is used to treat severe chronic pain in those that have serious pain disorders, like cancer. Until recently, fentanyl was only available in hospitals or through the prescribing of a doctor. Today, fentanyl can be produced on the street making it much more dangerous. Over the past 5 years, fentanyl has left a growing number of bodies.
Fentanyl is said to be 30-50 times more potent than heroin and 50-100 times more potent than morphine. A couple milligrams of fentanyl is lethal for the majority of people. The effects of fentanyl are often indistinguishable from those of heroin. It would be impossible for emergency medical technician to deduce simply by observing an individual that they are overdosing from fentanyl and not heroin. In some instances, they won’t know that they need to administer more naloxone, the anti-opioid drug to stop the overdose.
One of the major reasons that the drug is spreading so quickly is that it has a very high profit margin. Fentanyl can be mass produced and produces many more times the amount of weight for trafficking than a similar amount of heroin. A kilo of fentanyl can produce roughly 500,000 doses. The same amount of heroin might only produce 10,000.
Are Prescription Opiates a Gateway Drug?
Many believe that they are. Careless prescribing of prescription opioids has had a serious impact on what is now being termed “the opioid epidemic.” Doctors who have practiced in multiple countries believe that Americans are averse to pain and that American doctors believe that they can fix everything with a pill. The prescription of opioids for acute but temporary pain far exceeds the approach of pain management overseas. In some instances, opioids are being prescribed for things as simple as a toothache, where over-the-counter anti-inflammatory medications may be sufficient.
When patients are released from hospitals, they find themselves craving the drug. Many choose to indulge that craving. Hence why many of those who find themselves in the thrall of a major opioid addiction were once individuals that were prescribed the substance legally.
In addition, the black market distribution of these pills has incentivized individuals to make up symptoms in order to procure and then sell them. Pair this with pharmaceutical companies that are enthusiastic to market their product, doctors who are complying with patient requests, and easy access to these drugs on the street, and you have the making of a full-blown opioid epidemic.
The Long Term Effects of Opioid Abuse
Aside from running the risk of death caused by overdose, heroin causes severe physical and psychiatric problems for those that use it over an extended period of time. In addition, the drug takes over their entire lives, becoming their sole motivating factor. While other drugs, like nicotine and methamphetamine, are routinely cited as being more difficult to stop using, the comparison largely exists because the addiction profile of opioids, and heroin, in particular, are so high.
It doesn’t take long for a user to become addicted, and once they are, breaking the habit is exceedingly difficult. Long after the drug has left the body, the yoke of the addiction can remain.
In this section, we’ll discuss how heroin and opioids affect the brain and body. Generally speaking, all opioids have the same impact, but heroin has them to a greater degree. The high caused by the drug is thus more potent, and the withdrawal is that much worse. That’s why it’s routinely used as the standard when discussing opioids in general.
Heroin and Other Opioids Effects on the Body
One of the major issues with prescribing opioids to treat pain is that users develop a tolerance to the drug. The more they take, the more they need to take to produce the same effect. In short course, the drug begins producing as much pain as it prevents.
An opioid that is as potent as heroin can produce withdrawal effects within one day of not taking the drug. While the worst symptoms of withdrawal generally end after the first week, there are those that report experiencing symptoms after many months of not having taken the drug.
Those who take opioids habitually generally suffer from side effects like constipation, nausea, and insomnia. The drug also works as a respiratory depressant which slows breathing. When overdoses do happen, it’s usually because the opioid has stopped the victim from breathing entirely. Diseases and infections that impact the lungs are not at all uncommon for heroin addicts.
There are no safe methods of ingesting heroin. Still, those that choose to inject the drug will find that it takes a much larger toll on their body. Collapsed veins and blood infections are not uncommon. These infections can find safe passage to anywhere in the user’s body. Since heroin addicts generally don’t take their personal safety into consideration when they’re using, the rate of infection and disease among active heroin users is much higher than others. Venereal diseases like Hepatitis C and HIV are much more common among heroin addicts than the general population.
Heroin use is designed to produce a euphoric effect that is followed by several hours of blissful tranquility. Users who are high on heroin don’t generally have a very good idea of what’s going on around them. Many will die simply from choking on their own vomit and not being jarred awake by the fact that they can’t breathe.
The Effects of Heroin and Other Opioids on the Brain
As heroin binds to opioid receptors in the brain, it produces a flood of dopamine in the process. This naturally happens in the form of endorphins when something wonderful or exciting happens. Vigorous exercise can also produce the same effect.
The problem is that the individual’s brain can no longer produce dopamine without the aid of the opioids. For up to a year after ceasing the drug, users can feel a profound sense of emptiness, hopelessness, and depression. The reward center of their brain is no longer functioning properly. This can be reversed in time, but the brain must be retrained how to produce dopamine properly, and in the meantime, longtime users end up in a battle with severe depression.
In addition, studies have also shown that long-term opioid abuse deteriorates the brains white matter. This, in turn, impacts executive functions, decision making, problem solving, and the ability to regulate behavior. White matter is involved in the transmission of impulses from one part of the brain to another.
Heroin also appears to decrease the gray matter density in the frontal cortex, the area of the brain that manages our sensory input, speech, and executive functions.
In other words, long-term users end up severe brain damage from extended use of the drug.
The Effects of Heroin and Other Opioids on the Psyche
You’ve likely heard of the term “chasing the dragon.” The dragon, in this metaphor, is the pure blissful experience that the drug provides the user. But as the brain grows used to the drug, the effect is diminished with each dose.
Heroin’s addiction profile is unlike any other drug. While users have a higher rate of relapse for a drug like methamphetamine, heroin conditions a commitment to the drug that is unmatched by any other. Not only does heroin make you feel great for a short period of time, but it also makes you feel awful after the drug has worn off. Heroin punishes the user for not using and rewards the user for using. On a long enough time scale, heroin addiction becomes just as much about avoiding an awful feeling as it does about seeking out a pleasurable one.
Meanwhile, users who use heroin for a long time begin to develop a tolerance to the drug. They need more and more of the substance in order to achieve the same effect. As that happens, the torture of withdrawal becomes more and more painful. Heroin addiction is thus propelled by an irresistible urge to procure more of the substance at any and all costs. They develop antisocial tendencies, manipulating and exploiting anyone they can to get what they need.
As stated earlier, the opioid system is responsible for both the regulating of pain and the reward system as well. The brain becomes dependant on the drug in order to produce dopamine. As one of the most potent opioids ever synthesized, heroin produces an incredible euphoria within 10 seconds of taking the drug.
Another way to produce a similar effect is through rigorous exercise. Endorphins are the brain’s way of naturally producing the same effect that opioids like heroin do. Those that have gone through detox are thus encouraged to spend a lot of time exercising to help the brain produce endorphins. It helps former users through some one of the most difficult aspects of recovery. It can also help fight post-detox depression and retrain the reward center of the brain.
For those that are still heavy users of heroin and other opioids, the drugs become the center of their lives and eventually become their sole motivation. The drugs override all other desires as there is no other experience that can compare to the high of heroin. Like an abusive lover, heroin’s hold on the user is absolute.
The Persistance of Long Term Effects
Heroin addicts will spend the rest of their lives managing cravings for the drug. While recovery and abstinence are possible, they require a great deal of internal strength and willpower. Our brains have a tendency to romanticize pleasurable experiences while forgetting about unpleasant ones. In many former addict’s minds, the memory of the highs will override the trauma of detox. This is especially true with therapies that are aimed at reducing the symptoms as much as possible. The risk of relapse thus remains throughout the individual’s life.
While many users are left living with the consequences of their addiction for the rest of their lives, the human brain is remarkably resilient. It takes time to heal, and symptoms can last up to 3 years after the last use, but it does, in fact, heal.
Heroin and Other Opioid Addiction Treatment and Recovery
The idea of full recovery is a controversial one. For the purposes of this article, understanding that the battle against addiction is a lifelong process is important. It’s also important to note that heroin recovery is a process that can take anywhere from a year to three years to achieve what would be considered by medical professionals as a final stage. That includes giving the brain enough time to heal itself over a couple years of abstinence.
To say that heroin recovery is a process with no end is a bit cynical. Nonetheless, the temptation to use will last for the rest of a person’s life. That doesn’t imply that the damage heroin does to the body and brain isn’t reversible. Many individuals that were former heroin addicts do go on to live productive and rewarding lives. It just takes time.
Here, we’ll outline how heroin and opioid addiction is treated and what an individual who is just undergoing that process can expect.
General Addiction Facts
Symptoms of Drug and Alcohol Addiction
Drug and/or alcohol abuse can share some commonalities, of course depending on the drug. The physical nature of addiction can include:
- Visible change in habits;
- Loss of interest in family and/or loved ones;
- Loss of performance in school, or other favorite activities;
- Change in appearance;
- Weight loss;
- Glossy or bloodshot eyes;
- Dilated or tiny pupils;
- Sleep disturbances, sleeping too much, awake all night, or falling asleep at work;
- Unable to meet normal obligations, late for work or school;
- Scars and other signs of abuse or self-abuse;
- Tremors or slurred speech;
- Financial issues that cannot be explained, always needing to borrow money;
- Legal issues (driving while under the influence, fights, and accidents).
On the psychological side, symptoms may include (based on substance):
- Mood swings, irritability, sudden angry outbursts;
- Lack of motivation, person often appears lethargic or spacey;
- Paranoid, anxious, fearful;
- Agitated, unexplained high energy or motivation, silly behavior.
If you are experiencing any of these signs, or you know someone who is experiencing these issues, please seek help for yourself, or seek help (or a possible intervention) for the person who needs it.
Drug Specific Symptoms of Addiction
Stimulants (which include cocaine, crystal methamphetamine, and Adderall).
- Short-Term Symptoms: Excessive sleeping, loss of appetite, weight loss, dry mouth and nose, dilated pupils, hyperactivity, euphoria, irritability, anxiety, excessive talking, depression.
- Long-Term Symptoms: Chronic hot flashes, shallow breathing, a clouded mind and inability to think clearly, ongoing nausea and regular vomiting, inability to hold down food, chronic drowsiness, a drop in body temperature, coma and possible death.
Opioids (which include prescription painkillers and synthetic heroin).
- Short-Term Symptoms: Chronic coughing, sniffling, twitching, loss of appetite, sleeping at unusual times, sweating, vomiting, contracted pupils, no response of pupils to light, needle marks.
- Long-Term Symptoms: Weight loss, loss of appetite, skin deterioration, sexual dysfunction (impotence, or inability to achieve orgasms for women and men), cold sweats, depression, low energy, loss of motivation, memory loss, personality change, mood disorder, bowel issues, constipation, dental problems, rotting teeth, gum inflammation, permanent respiratory damage or breathing issues, immune system compromise, interruption in menstrual cycle for women, introversion, teeth abscess, Hepatitis C, liver disease, HIV and/or full-blown AIDS (from intravenous drug use), collapsed veins, heart failure, tuberculosis, arthritis. (Note: Heroin is among the most addictive of all drugs, regardless of exactly how it is ingested. The fastest way for heroin to reach the brain is by smoking it, or injecting it. Once a person becomes addicted to heroin, nothing that was once important to them matters. Their only purpose in life is to use more heroin. As such, withdrawal from this drug is among the most difficult of all.
- Common Withdrawal Symptoms from Heroin: Vomiting, diarrhea, restless leg syndrome, extreme nausea, major aches and pains, insomnia, moodiness, flu-like symptoms, including high-grade fever.
Inhalants (which include glues, markers, aerosols, and other vapor-inducing products).
- Short-Term Symptoms: Drowsiness, poor muscle control, changes in appetite, anxiety, irritability, watery eyes, impaired vision, memory and thought, secretions from the nose or rashes around the nose and mouth, nausea, headaches.
- Long-Term Symptoms: Nasal polyps, cancer, blackouts.
Hallucinogens (which include LSD and PCP, among others).
- Short-Term Symptoms: Slurred speech, confusion, aggression, hallucinations, mood swings, detachment from people, dilated pupils, strange and irrational behavior including paranoia, unusual preoccupation with objects or one’s self.
- Long-Term Symptoms: An inability to trust reality, loss of trust in general.
Sedatives (which include the following tranquilizers – GHB, Xanax, Valium, Klonopin).
- Short-Term Symptoms: Clumsiness, poor judgment, slurred speech, sleepiness, contracted pupils, drunk-like state, difficulty concentrating, memory loss.
- Long-Term Symptoms: Loss of motor control, stroke, heart failure.
- Short-Term Symptoms: Agitation especially if you are unable to immediately drink again, pining for other drugs if alcohol is unavailable, blackouts, obsession, temporary deficiency of motor skills, lack of judgement and clear thought, loss of life.
- Long-Term Symptoms: Alienation of family or friends, job loss, liver damage, loss of finances, abusive tendencies, death by vehicular accident or alcohol-induced loss of organ function. Agitation if you are unable to drink.
- Outside Warning Signs of Drug Alcohol Use in General: Family and friends comment on your use, a medical professional warns you to stop drinking, you ignore or deny that you have a problem when the above signs are present to those with whom you associate.
Common Issues Related to Addiction
Addiction has numerous dangerous and potentially damaging consequences, including:
- A depressed immune system: People who are addicted to a drug are more likely to receive a transmittable condition, such as HIV or Hepatitis C, either through harmful sex or by sharing needles.
- Self-destructive tendencies: Individuals who are addicted to drugs and alcohol die sooner than those with no addictions.
- Other health issues: Drug addiction can result in a variety of both temporary and long-lasting psychological and physical illnesses, depending on the type of substance that is used
- Accidents: Individuals who are addicted to drugs are more likely to drive or engage in other risky activities while drunk or under the influence of drugs, both illegal and prescribed.
- Problems in the home: Most often addicts experience problems with relationships at home and with friends.
- Financial issues: Addicts often experience financial difficulties due to their lifestyle, which frequently leads to debt or dishonest behaviors
- Legal problems: Legal issues are common for the addict such as arrest, domestic, and warrants
- Suicide: Addicts have a considerably higher degree of suicides than those not addicted
- School and employment issues: As addiction leads to a lack of motivation. School and work take a back seat to the addiction.
The Psychology of Addiction
Why do individuals become addicted to alcohol or drugs? Are certain people more prone to addiction than others? Do you believe you have an addictive personality?
Have others told you there is something different about you lately?
Drugs and alcohol alter brain chemistry, to a degree that often causes an insatiable craving for more. Addiction is not simply a sign of weakness, as some seem to believe. “He can stay away from drinking if he wants to,” some may say. Or, “She doesn’t want to stop using. She can quit at any time.” Or, “They just like to party. There’s nothing wrong with that.”
On the other side, you hear comments like, “If he really loved me and the kids, he would stop.” Or, “She just needs to get some control over her drinking.”
Unfortunately, none of the examples are truly representative of the issue at hand. For those in the throes of addiction, loving another may be a reason to stop, but physically the physical and emotional grip of the addiction has been tightened to where stopping cold turkey is immensely difficult, and frequently near-impossible to do without professional help.
Simple willpower is rarely enough.
Drugs affect the brain’s communication system by tapping into its reward center and altering the message that is received. For example, Oxycodone is prescribed by doctors for relief of pain, because it alters your brain chemistry as to your perception of that pain. Physiologically, Oxycodone (an opioid painkiller) floods the brain with Dopamine, a chemical that sends a message to the brain that says, “I feel good.” The danger comes with the misuse of the chemical, not from the correctly prescribed usage.
Of course, following certain surgeries, or to relieve pain for a terminally ill patient, such a medication is useful and needed. However, for long-term treatment, opioids can be extremely addictive and dangerous. Your body easily builds a tolerance, and when that happens it will cause you to constantly crave more to attain the same effect.
For example, among the most common surgeries for seniors or younger athletes are outpatient joint replacement surgeries. Most of these surgeries are relatively simple, though the healing time can take up to a year. Opioids typically prescribed to fight considerable post-op pain include Tramadol, Hydrocodone, and/or Meloxicam. The cycle worsens due to the most common complaint among such surgeries: a lack of sleep. Sleep deprivation will only increase the severity of the pain, as the nerve centers are that much more sensitive than typical. More pain leads to self-medicating, which in turn frequently leads to increasing dosages with or without the doctor’s knowledge.
Wyoming, as an opioid stronghold, knows these issues all too well. Abuse and addiction to opioids such as heroin (synthetic), Vicodin, Oxycodone, Percocet, and Morphine is actually a severe worldwide issue that impacts the social and financial well-being of all of us regardless of where we live. For perspective, in 2012 it was estimated that between 26.4 million and 36 million individuals abused opioids worldwide. Of that number, approximately 2.1 million individuals in the U.S. were dealing with substance use disorders connected to prescription opioid pain relievers, and an additional estimated 467,000 were addicted to heroin.
Five years later, in 2017, those numbers are estimated to have increased by over a third.
Addiction materializes in three distinctive ways:
- Craving for the drug;
- Loss of control over use of the drug; and
- Continuing to use regardless of damaging effects.
The word “addiction” originated from a Latin term for “bound to” or “enslaved by.” Any person who has struggled with addiction, or has tried to help a loved one who is or was suffering from addiction, surely understands the truth of this translation. Addiction can begin innocently enough, and frequently does, with an experimental or recreational use of alcohol or drugs in a social situation. For some, however, such innocuous experimentation or recreation can signal the beginning of more frequent use.
One of the difficulties of that equation is we just will not know until we get there. In other words, we have no idea if a simple drink, for example, will lead to anything more. Individual addiction tendencies are based on how our brain centers react to the substance.
As it regards opioids, drug addiction begins with direct exposure to prescribed painkillers, or by obtaining medications from a friend or relative that has been prescribed the medication, and discovering that the drug is not enough to cure the pain. Opioids suppress the pain, first of all. They cure nothing, but for someone who suffers, that fact makes no difference. Many will misuse the painkiller simply to feel better.
Both the threat and speed of addiction varies by substance, and is dependent on the individual. Some drugs, such as opioid pain relievers, are more dangerous and lead to addiction quicker than others. As time passes, the afflicted may require greater dosages of the drug to get high. Before they know it, a person can feel they need the drug just to feel normal or just to get through the day. As substance abuse progresses, one may find that it’s increasingly difficult to go without the drug for even short periods of time. Once tolerance builds, if a doctor refuses to prescribe more, the new addict will frequently turn to the street for help.
Is addiction learned, or is addiction genetic?
As with many other diseases, addiction vulnerability is very complex, and nearly impossible to determine. Variable factors, such as environment and genetics, determine the likelihood that somebody will become an addict. Since addiction is a complicated illness, locating the specific gene that causes one’s addiction is a difficult proposition.
Genes and environment can add up to create more of a risk, or they can cancel each other out. Not every addict will carry the exact same genetics, and not every person who carries the addiction gene will become an addict. Researchers tend to study larger families to learn which genes may make a person more susceptible to addiction. Studies have shown that children of parents who abuse drugs or alcohol are more likely to innately have, or develop, an addictive personality.
The so-called “addiction gene,” however, has yet to be defined, or found. The concept is theoretical, and work is done every day by medical professionals to isolate such a gene – if it even exists – in the effort to target the reasons for (what they believe to be) genetically predisposed abuse.
Understand, addiction is not a curable disease. However, addiction can certainly be managed with proper medical treatment, in addition to continued education on the part of both the addict and the medical professional, and continued research on the part of the medical community. Further, with the aid of such continued studies and the discovery of more effective and less addictive medications, alcoholics and addicts can continue to safely withdrawal and move forward on their road to recovery.
One hopes that scientific advances will one day make the process that much easier.
An Addicts Obsession Explained
Obsessions are not endemic to addiction, as most human beings suffer from obsessions to a degree. Also, there is more than one type of defined obsession, which we will list below. For an addict, though, obsessions generally morph to an extreme and highly unhealthy level.
An addict’s obsessions can be triggered in several ways. We hope by listing the below you will garner a better understanding of those nagging thoughts that can be troubling to you.
General obsessions, taken to an extreme by an addict, can include the following:
- Invasive Obsession is the idea of using that appears to enter our minds from out of nowhere. When we are struck by an intrusive thought, we find ourselves instantly dropping our recovery tools, and our important duties, to pick up that drug, drink, behavior, or person.
- Recurring Obsessions happen when the idea of using enters our minds over and over throughout the day. Combating this thought exhausts all our energy. We continue to remind ourselves of the significance of not using, of all the important things we will lose if we use again, and of exactly what always happens to us when we are on a using spree. The thought of using recurs throughout the day, and seems to grow stronger with time. If we can hold out against the repeating obsession, we tend to be exhausted and dispirited. We are irritated to find that even normal daily tasks require an immense amount of energy. Even if we do not give in, the returning obsession wins by wearing us down
- Circumstantial Obsession happens to an experienced user when we are presented with the opportunity to use or drink out of nowhere, and then we suddenly become obsessed with the idea and can think of no reason good enough not to repeat old, destructive behaviors. We may provide ourselves with some ridiculous reason for justifying our drinking or using. Or, we may just automatically go on auto-pilot, and before we even know exactly what happened, we are back full force into our addiction or alcoholism.
- Fundamental Obsession is not about drinking or using per se but a constant preoccupation with ourselves. We become so uncomfortable in our own skins that we become extremely irritable and discontented. We also feel that if we cannot find a spiritual remedy, we are surely doomed. Those of us who have been sober for extended periods of time without a spiritual solution, know the pains of essential obsession all too well. Life is unfulfilling, and we are continuously flustered. Or, all too frequently we feel troubled and depressed. We are unable to create purposeful or lasting connections. We have a deep dread because we feel that life is treating us unjustly. We are overly sensitive, and people seem harsh and ignore our needs (Woe is Me Syndrome.) Regardless of what we attempt, we do not appear to be able to find any satisfaction. We are frequently looking outside ourselves to find some comfort. We may have an obscure sense that something is wrong with us, however, we do not know what it is. Depression issues are common to those who suffer Fundamental Obsession.
Recurring and Circumstantial Obsession might be easier to cope with over time, yet the Fundamental Obsession tends to worsen. The pain of everyday living accumulates inside us and without continually working on our recovery, we act out in various ways. We might become aggressive and complain, which can become a drain on our relationships to our friends, families, and employers. A lot of us change addictions, possibly to food or some other destructive behavior that provides us with short-lived relief. In other words, we change dependencies to deal with the pain.
Regardless, so as not to end this section on a downbeat note, there is indeed always hope from drug and alcohol addiction. With the proper treatment and aftercare program, you can immediately begin your road to recovery.
Any in-depth discussion of a given state’s drug issues should include general guidelines of treatment. You will notice that the list that follows also includes words about family and friends, as they may be among the most important aspects of both your addiction, and subsequently your recovery.
If you are going it alone, and you have no such relationships to speak of, the following will nonetheless prove valuable as you will be surrounded by treatment professionals and, likely, fellow users or former users throughout your recovery process.
We strongly advise you to keep this list nearby, and refer to it whenever you need some reminders that hope is nearby:
- Addiction is a brain disease that also affects your behavior. Addiction is not your fault.
- Treatment does not have to be voluntary to be effective. It can be court ordered, employer referred, or family or friend-related. People have success even when it’s not their idea.
- Getting help early in the addiction is always the best solution.
- Everyone is different and needs a treatment plan designed specifically to meet their needs. There are so many different types of treatment; find one that suits you.
- A good treatment facility for you will address all areas of your life, not just your chemical addiction. Said facility will delve into your interpersonal relationships as well.
- Mental wellness problems are typically connected to drug addiction, and should be examined and addressed in your treatment.
- Any prudent and effective treatment program will evaluate for transmittable diseases such as HIV, Tuberculosis, and Hepatitis C.
- Commit to your treatment program for an adequate time to give yourself the best chance for success.
- One of the most common types of treatment is Behavior Modification – which might involve some combination of group and family-specific treatment. The reason for the potential group and family involvement is to address issues within your life in general, and outside of the treatment facility.
- Physical detox is important, but remember, it is only the initial stage of your treatment. Long-term behavior modification generally requires a process of behavioral therapy as well as ongoing follow-up.
- Medication is usually needed in conjunction with treatment. Do not skip, or cheat on, any medications prescribed by your treatment professional.
- The best treatment programs will monitor you for any type of possible relapse behaviors throughout the course of treatment.
- Treatment plans should be continually revised to fulfill your current circumstances.
Addiction and Crime
It is difficult to discuss drug addiction without mentioning its links to crime. Untreated addiction may not only affect the addict and the addict’s immediate loved ones, but the entire community. Drug addiction has been linked to crimes such as theft, child abuse, neglect, domestic violence, and even murder.
A drinking problem by its nature brings with it a reduction in inhibition. Such a response may harm an individual’s reasoning, and increase the threat of hostile behaviors.
Both drug and alcohol-related violence and criminal activity rates continue to increase throughout the country. The following activities can include severe repercussions such as time in jail, legal costs, and/or various other court-ordered fines:
● Driving under the influence
● Destruction of property
● Sexual assault
● Aggravated assault
● Domestic abuse
● Child abuse
An addict can not always make a clear-headed decision. If you believe you can, then ask yourself this question:
“Is it worth it?”
Further Notes on Alcohol
Alcohol is the most commonly abused addictive substance in the United States, and has been for many years. 17.6 million U.S. residents, or one in every twelve adults, experience alcoholic abuse, in addition to several million more who participate in dangerous, binge drinking patterns that could cause alcohol addiction. More than half of all adults have a history of addiction or alcoholism in their family, and more than 7 million kids live in a home where at least one of their parents is abusing alcohol, or has in the past. As with Wyoming, alcohol is frequently a gateway substance to harder drugs nationally, especially with teenagers.
Many people drink alcohol simply to cope with troubles or to avoid tough feelings; as such, it is often difficult on the part of the problem drinker to identify that they have a problem at all. Denial is just one of the primary reasons that millions of individuals do not obtain treatment for alcohol abuse.
Alcoholism is the disease that results from an insatiable need for, and use of, alcohol. A doctor will diagnose the extent of your issues, though we cannot encourage you strongly enough to find help immediately if you do believe you need it. Too many people rationalize their drinking, which can hurt them as well as others. For instance, some may say, “I’ve never had a DUI.” Or, “I don’t drink in the morning.” Or, “I’m fully in control.
Regardless of the excuse – and any justification is exactly that, an excuse – an unwillingness to truthfully acknowledge the negative issues you have experienced from alcohol can lead to defensiveness when confronted about it.
By refusing to recognize the negative consequences of alcohol, you will avoid living a healthy, sober life that is there for the taking.
If others can live that life, why can’t you?
Addiction, Family and Friends, and Codependency
Before we take a comprehensive look at treatment, one more subject beckons. To that subject, we would like to ask you a question:
Have you ever enabled a drug or alcohol addict?
Chances are you have, and you didn’t know you were doing it. Chances are you may have even received your own reward for having done so, without identifying that either.
In any relationship, codependency (as well as further addiction) occurs when one person may abuse drugs or alcohol, and the other individual allows them to continue the behavior by making excuses for them such as calling their workplace and reporting them sick, or giving them money. Both the addict and the well-meaning enabler need one another, which further enables the abuse cycle.
Codependency can be either a learned behavior, or an inherited behavior that can be passed from one generation to the next. It is both a psychological and behavioral condition that affects both parties’ capacity to engage in healthy connections with another human being. It is additionally known as relationship addiction, due to the fact that people with codependency usually develop or maintain relationships that are dysfunctional, one sided, psychologically devastating, and/or abusive.
Codependency as a term and an unhealthy proclivity was defined following long-term examinations of family members of alcoholics. For many, codependent habits are inherited by watching and imitating various other members of the family who present these sorts of characteristics. For example, the spouse of an alcoholic may expend all of her energy worrying, thinking, and trying to manage the chaos and problems that come along with the alcoholic. She must make sure the kids are taken care of, make excuses for her husband, as well as assume more responsibilities of everyday life as the alcoholic frequently is no longer capable. But, metaphorically, a juggler cannot keep juggling forever. At some point the juggler will run out of steam and become exhausted. All the balls would fall to the ground.
This is the greatest issue with the non-addict codependent. Then, when those balls fall, the addict can no longer count on the person they may have trusted more than most.
Many of the non-addict codependent parties believe they can “fix” or “control” the addict by enabling their habit. Making excuses for an addict in any way is enabling them. This cannot sustain, however. One becomes completely fixated on the alcoholic or addict, and continues to enable their destructive behavior without even realizing it. All too often, once the non-addict party realizes what they are doing, the addict is too far gone to be helped.
This why precisely why, in the rehabilitation process, family participation is so important. Both parties must learn about the issue. If nothing changes in their environment or in their primary relationships, it is almost guaranteed the addict will drink or use again.
One more point regarding this subject: Low self-esteem is the trademark of most codependents. Many are always searching for anything or anyone outside of themselves to change the way they feel inside. This could be another person, a circumstance, nicotine, drugs, alcohol, sex, food, or any other entity upon which they can focus.
The non-addict codependent most always has the very best of intentions in their hearts and their minds. Those intentions are sincere. This codependent cares for an individual who is experiencing a problem, yet their caretaking becomes obsessive and destructive. They frequently take on the role of the benefactor of everyone’s needs, and assume the role of the martyr in the relationship. This codependent can be a father covering up for his child being late to school, or an employer constantly allowing poor work habits or tardiness to slide, or a mom who calls in a favor to get her daughter out of trouble. This type of help, however, is only fuel for the addict to continue to use longer and create more damage and consequence from their destructive behavior.
It is not possible without proper training and education in the treatment for addiction for a loved one to truly help an individual with alcoholism or addiction. That is why medical intervention is so immensely important.
Signs you may be in a codependent relationship may include
- An exaggerated feeling of responsibility for the actions of others, in this case an addict
- Having trouble making decisions
- Poor communications skills
- Chronic anger
- Lying or dishonesty in an ongoing effort to help the addict
- Irrational guilt when putting themselves first or saying “no”
- A tendency to do greater than their share of work, or having to do it all so it gets done correctly, or completed at all
- Becoming hurt when people do not acknowledge how much they do for them
- Continuously getting into unhealthy relationships, due to an inability to be alone or otherwise;
- A willingness to do anything at all to hold on to a connection and avoid the feeling of desertion
- An extreme need to be in control and be receive recognition
- Having to be in control of others and manages their lives
- Trust issues with others and self
- Fear of being deserted or alone
- Difficulty identifying one’s own feeling
- Rigidity or inability to cope with change
- Issues with intimacy and/or boundaries
- Confusing love with pity
- A consistent need to rescue the other, or another, party
As codependency on the addict’s part is usually rooted in their early early life, and is common to an addict, treatment will include therapeutic explorations into early childhood, and/or young adult issues. Treatment may incorporate both private and peer treatment through which co-dependents unveil themselves and determine their self-defeating behavior patterns. Effective treatment will help you reconnect with emotions that have been long-buried, as well as on rebuilding your interpersonal relationships to a more healthy level.
Your treatment, if diligently followed, will help you either regain your life – or otherwise build the life you want – in all facets.
On that note, as we’ve shared a great deal of background that will hopefully help you better understand the nature of your addiction, allow us to delve into the concept of your treatment in earnest.
The Treatment Process
The Multiple Stages of Abuse
Your treatment will begin with a determination as to where you are in your addiction. The initial stage of substance usage is experimental. If the high or other desired effect is attained, recreational use usually follows. For those who choose to experiment with either alcohol or drugs, and said desired effect is not attained, the majority go no further or perhaps try once more following their first use.
Most, however, do attain their high, which leads to the problem.
Continued use is the second state, and tolerance is the third, as the user will look for bigger fixes as old tolerances no longer apply. Abuse is the fourth stage, followed by addiction.
Among the steps that must be taken to support the struggles of an addict, while breaking him or her away from their addiction, include: removing the addict from their negative environment (including the company of dealers and fellow abusers) and placing them within a therapeutic community, the necessity of entering a rehab program and participating in psychological and emotional counseling (and sometimes physical rehab), and how to spot triggers so as to hedge against relapsing.
Pre-intake is the process whereby a concerned user believes they may have a problem, and they begin the process of seeking help. Ask yourself the following questions:
- “How long have I been using?”
- “Do I believe I have a problem?”
- “Do I think others who know me believe I have a substance-related problem?”
- “Does it matter to me?”
- “Have others confronted me with questions related to substance abuse?”
- “Do I use alone, or in hiding?”
- “Have I ever substituted one drug for another, thinking one particular drug was the problem?”
- “Do I find the thought of running out of drugs scary?”
- “Have I ever been in a jail, a hospital, or a drug rehabilitation center because of any using in the past?”
- “Is this what I want with my life?”
If you find your answers to the following questions alarming, we suggest that you follow up with other, more positive questions:
- “What are my life’s goals?”
- “Where do I want to be in my life one year from now?”
- “Where do I want to be in my life five years from now?”
- “Where do I want to be in my life ten years from now?”
If like many users you cannot answer such goal-related questions, try this: “Where do I want to be tomorrow?” If your answer to this question is dark, or bleak, and related to depression, it’s time to seek treatment. Similarly, if your answer is something positive, the very fact that you have come to this point and have begun researching options also means it’s time to seek treatment.
If you do, your tomorrow may be exactly what you want it to be.
A brief disclaimer: As with any other self-diagnostic tool, questions such as these are exploratory only. You must speak to a trained and licensed professional for any true diagnosis. Still, answering these questions can be extremely useful, and insightful. Remember, if you are under the influence as you answer, you may not be the best arbiter of your responses. If, however, you can be truthful with your responses, the results of your subsequent efforts can be invaluable.
In one sense, this section is most appropriate for family, friends, and associates of the addict. However, in the spirit of openness, we include it here so you can understand how your addictions can affect others. If you believe you need help, then we strongly suggest you follow that gut instinct. If, however – for whatever the reason – you believe you need help prior to entering formal treatment, we have a suggestion. Speak to a friend, a family member, or an otherwise trusted associate. In an ideal situation, speak to someone you trust who has dealt with addiction issues. Ask them if they could help you, whether practically or by recommending someone who can work with you towards treatment. If you have no one you can trust, which is common for a user, then we suggest contacting one of the organizations on this page and speaking to them about your issues, or concerns. If you come to believe an intervention may be in your best interests, but want to know more, here are some common elements practiced by an interventionist:
- Planning, preparation, and engagement of the intervention.
- Advisement of specific and appropriate treatment and rehab programs.
- Sensitivity issues in working with a user.
- Preparing all arrangements, including family consultation so they know what to expect.
- Continuing to work with the family – or friends – of the addict while they are undergoing inpatient or outpatient treatment.
- Arranging of all logistics, including payment and/or insurance requirements, and arrival.
- The interventionist also sets ground rules as to how to interact with the user:
- Do not get upset with your family member, or friend, during the intervention.
- Avoid verbal labels during the intervention, such as “junkie,” “addict,” or “alcoholic.”
- The mindset is to not have the addict defined by their addiction.
- When deciding who to include in the intervention – again, friends and/or family of the addict (as we will continue to say for clarity’s sake in the context of these articles) – the number of people who attend must be kept to a minimum, and managed.
- Never perform the intervention if the addict, or another member of the group, is intoxicated.
- Many interventions are initiated against the will of the user, by concerned associated parties.
- Television sometimes reinforces the myth that all interventions are violent, or potentially dangerous. Consider this: Is your addiction potentially dangerous?
If you find yourself as a surprised and unwilling subject of an intervention, those in charge are taking the action in your best interests. How you respond is, of course, up to you. However, note that the interventionist is there to help you, not hurt you.
Intervention can be a highly-effective tool when prudently undertaken. Those in charge have an immense responsibility to you and your safety, and they take that responsibility seriously.
More on Intervention Services HERE.
Detox can be a dangerous process and the best detox facilities will always suggest that the process not be attempted alone. Under the supervision of recovery specialists, detox can go smoothly. Medical conditions can be monitored closely, and medications administered to help the patient through the difficult process.
The Option of Rapid Detox
Rapid detox, or ultra-rapid opioid detoxification, was developed to reduce hospitalization time during detox. At rapid detox centers, doctors administer naloxone to trigger withdrawals then administer a mild sedation to relax the body during the detox period. The goal of rapid detox is to allow the patient to sleep through the difficult and often painful symptoms while the body eases out of physical dependency.
Why Use Rapid Detox?
The speed and efficiency at which rapid detox takes patients to the next level of treatment is very quick. None of the severe symptoms have been experienced and the patient is ready to move onto long-term treatment.
Why Not Rapid Detox?
Some recovery specialists feel that the harsh experience of traditional detox has long-term benefits. The grueling symptoms are reminder of the hold drugs has had on the addicted. Without that experience, some feel that it is much easier to relapse. There is also the concern that the process itself can be harmful medically, though there is no hard evidence or cases that suggest any physical harm from the process.
With traditional drug detox is recommended, a patient must prepare for the severe withdrawal symptoms. For some drugs like heroin and alcohol, the feeling of “tearing up” has been described by those who have gone through it. Withdrawal symptoms usually occur within a few hours of detox. Symptoms may include:
- High tension
- Constantly runny nose
- Severe chills
- Disturbed and fitful sleep
- Extreme nausea
- Muscle pain and stiffness
- Muscle spasms
- Difficulty breathing
- Trouble concentrating
- Achy bones
- Racing heartbeat
- Extreme feelings of Anxiety
- Severe headaches
Medications that Help with Detox
Depending on the addiction, a variety of medications can be administered during the detox process to manage the extreme withdrawal symptoms. Ways to ease withdrawals or heroin include the following carefully controlled medications:
Medicines for Heroin
Methadone is the most often used for heroin addiction. The value of methadone is that the prescribed dose can be can reduced over time.
Buprenorphine is an alternative option to heroin and prescription opioid medication addiction. Buprenorphine has the advantage over methadone as it can help manage cravings without producing a high.
Medicines for Alcohol Addiction
Naltrexone blocks receptors that reward the brain for drinking alcohol. This medication also helps minimize cravings.
Acamprosate helps reduce the symptoms of long-term alcohol abstinence including insomnia, anxiety and restlessness that often compel alcoholics to return to drinking.
Medicines for Meth Addiction
This medication reduces meth cravings but requires close medical monitoring and is usually only prescribed within an inpatient environment.
Rivastigmine also has helped meth addicts reduce cravings and is used as an alternative to dextroamphetamine.
Medicines for Cocaine Addiction
Gabapentin helps prevents the seizures that are sometimes associated with cocaine detox. The medication has also helped many addicts regain a sense of well-being during the long-term recovery process.
Modafinil has helped many recovering cocaine addicts with the fatigue and drowsiness that occur during cocaine withdrawals. Often one of the worst aspects of cocaine recovery is not getting enough sleep and this medication helps with this withdrawal symptom.
Detox addresses the physical hold of an addiction. The length of a detox program will vary based on several factors, including the nature of the addiction, and of the addict’s personality. Regarding the former, chemical dependency frequently occurs that must be medically handled, as your brain has become fully dependent on further use of the substance in order to function. This is a medical issue that will frequently require medication to handle.
During the early phases on detoxification, withdrawal will occur which can be a painful process. Your system will be cleaned of the drug, and your brain will learn to operate as it once did. Certain withdrawal symptoms can be life-threatening, which punctuates the importance of full and systemic treatment.
Factors that can influence the longevity of the detox aspect of your treatment program include:
- Multi-drug abuse;
- Pre-existing medical or mental health conditions;
- Your level of dependence;
- Previous trauma;
- Environment (both that of your home life and the environment of your support system)
The concept and practice of detox is typically broken down into three distinct phases: Evaluation, Stabilization, and Transition to Inpatient Drug Rehabilitation.
Evaluation: As overseen by a doctor, who will determine what drugs are presently being used, how long has the patient been using, and how much and how frequently the patient uses.
Stabilization: As expounded on the site, stabilization differs patient to patient, based on specific substance being abused. This is the end result of the withdrawal phase.
Transition to Inpatient Drug Rehab: Many addicts believe that once they complete withdrawal, they are finished with their treatment. That is a dangerous belief, as withdrawal only releases the immediate physical hold of the substance. Again, only the trained professional can make the determination of to your further treatment needs.
Many users incorrectly believe the process of detoxification to be the same for everyone. This is a common fallacy. There is more than one detox method that can be undertaken by an addict. Your treatment professional will recommend the correct process for you, which can include one of the following options: Medical Detox, or Ambulatory Detox.
A) Medical Detox. The most typical detox process, medical detox is implemented so the user can safely withdrawal in a facility with qualified medical professionals present at all times. Detox centers from drugs and alcohol are an effective alternative for individuals gripped by misuse. Frequently, when an addict tries to cut back or entirely quit using alcohol or drugs on their own, they could have withdrawal symptoms that are seriously harmful. As such, clinical detox is usually the first step prior to checking into inpatient treatment center.
Everyone’s experience with withdrawal is different depending on what type of substance they are addicted to. Alcohol, as well as some narcotics (benzodiazepines, opiates), can be life threatening to detox from on your own. Heroin is notoriously brutal to withdrawal from, though most times not life-threatening. The difficulty lies in the nausea and discomfort that follows; if not treated inside medical detox, the symptoms cannot be easily tolerated by some addicts and the person is more likely to score heroin to feel better, therefore creating a vicious cycle of addiction. Cocaine and pot have a less physical, and more emotional, detox process. Regardless, the safest way to withdrawal from any drug is to be surrounded by qualified medical staff. If the chemically dependent person is abusing alcohol, opiates, heroin or benzodiazepines, medical detoxification of some kind is most often necessary for the person’s safety.
B) Medically Monitored Ambulatory Detox. Though most frequently medical detox from alcohol and chemical abuse takes place in an inpatient setting, where the individual remains at the center for up to ten days, there is a second option for less severe withdrawals. In Ambulatory Detox, the patient remains at the treatment center throughout the day, and they return home at night. A program like this allows an individual to detox safely while keeping up with most of their daily responsibilities.
Whichever detox method is selected for you will be based on many factors, most notably the degree of your use, and prognosis of your withdrawal. A treatment professional will work closely with you to determine the efficacy of certain treatments in any case, and it is important to understand that they are highly-trained in such treatments, and decisions.
Inpatient Treatment Services
Post-withdrawal, the process of your ongoing recovery can be either inpatient or outpatient. Inpatient treatment is appropriate for more severe cases, and the generally more flexible outpatient treatment is geared towards those with a more moderate addiction (though addiction is still addiction) and a stronger support system in their home environment.
Inpatient treatment can either be a PHP (a partial hospitalization providing a highly-structured environment, with typically active treatment of 30 hours per week), the less-intensive IOP (intensive outpatient treatment plan, which requires up to three hours daily over 3-5 days, for a total of nine hours weekly; therapy is usually included, but the patient can live either at their own home or a halfway house during the process), or an RTC (residential).
Most inpatient therapies, regardless of option will last 5-10 days. They can last longer based on the severity of the problem, and the patient’s physical and mental fitness.
Among its services, a PHP will most frequently incorporate intensive one on one therapy in its treatment program. The reason for this is most PHP admissions are due to disturbances in behavior from the drug being abused, or for those who experience otherwise increased symptomatology. In a PHP, the patient is often isolated and of no risk to other patients.
PHPs and RTCs are highly-structured treatment options. PHPs are the most structured options of all. If you have little structure in your home environment, both of these invaluable choices will likely take some time getting used to. That said, the importance to your overall treatment plan cannot be understated.
Note: Substance use disorder treatment is listed as one of the 10 Most Essential Health Benefits of the Affordable Care Act, meaning that your care is covered if you have health insurance. If you do not have insurance, many treatment centers offer financial aid.
Always ask when you speak to a treatment advisor if this is a concern, as inpatient treatment is typically more expensive than outpatient.
Outpatient treatment is often preferred when one has substantial duties in their outside environment, such as school or family. In fact, family and friend group therapy is often included in this option, which is quite flexible in its scheduling. Outpatient treatment has proven to be very effective for those with underlying causes for their addiction, such as eating disorders, to grasp the root of their substance-related issues in a more relaxed setting among familiar support systems.
As an outpatient, you are not enmeshed in a structured environment, you live at home and you are not under constant supervision.
However, outpatient treatment is no less important or helpful than inpatient treatment. Though the scheduling of your appointments may be flexible, you still need to commit to the time. If you miss one appointment, you will likely miss another.
Ask yourself if you are responsible enough for an outpatient program. If you are, and you maintain your treatment, the rewards can be innumerable.
Both inpatient and outpatient treatment are comprehensive approaches to wellness. You will face temptations in both but as long as you remain responsible, you will also learn specific strategies as to how to deal with them. It is up to you to take advantage of those lessons.
Click the link to learn more about the differences between Inpatient vs. Outpatient
Aftercare and Sober Living
Sober living may be the final step in your formal treatment plan before returning home, but treatment never really ends. Sober living houses provide the interim environment between rehab and mainstreaming back to your natural environment. The reason for the initial formation of sober houses was simple: a person in recovery frequently needed a safe and supportive place to stay, during the vulnerability of early recovery, prior to returning home.
Sober houses are also highly-structured, and most residents are referred to a sober living environment from a rehab center. Requirements and rules are strict, and they usually include:
- No drugs or alcohol on the premises;
- No violence;
- No overnight or sleepover guests, not even family;
- Commitment to random drug testing;
- Involvement in a community-related program;
- Acceptance by a peer group;
- Acceptance of advice from treatment professionals;
- Respect for the rules of the house;
- No swearing;
- No stealing;
- No sexual activity between residents;
- As part of a recovering community, if you see or hear any resident breaking the rules of the community, they must be reported immediately to appropriate staff;
- Anyone on prescribed medication must inform the house manager upon admittance;
- Residents must attend all sober house meetings;
- Residents must submit to drug and/or alcohol tests upon request;
- Rooms must be clean at all times;
- Chores must be completed without argument;
- Curfew must be respected;
- Client must attend all therapy sessions, group or individual.
Many of the above rules are enforced with a Zero Tolerance Policy. Meaning, if any of these rules are broken even once, you risk being kicked out of your sober living home. If you had experienced structure during your prior treatment to this point, you should be in good shape.
A benefit of many sober houses is that staff frequently are former addicts themselves. This is a benefit for two primary reasons: 1) They understand the struggle, and 2) They are living examples of former addicts who have successfully completed treatment and are now giving back. Some of these former addicts work on salary, and some happily volunteer their time.
Sober houses are most successful when utilized (in conjunction with a formal treatment plan) for a designated period of time. Do not expect all residents to attain equal success during this stage. You will likely come to know your peers through intensive group counseling. You will also undergo one-on-one therapy, but in the group setting you will notice your peers’ various stages of recovery. You will form opinions but always remind yourself that you are there for reason.
And that reason is to take care of you.
An important note: Recovery from alcohol or drug addiction does not end after your formal treatment plan. Addiction is, indeed, incurable; however, addiction can be arrested and remain that way with prudent post-sober house, or aftercare, strategies. Committing to a further aftercare program, for example, reduces the probability of relapse and helps keep you connected to drug and alcohol counselors and peers who are going through, or have gone through, similar experiences. With increased awareness comes a better understanding of life’s stressors and how best to deal with them.
Nothing has proven to be a more successful method of care in reducing the risk of destructive behavior than ongoing education and awareness.