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Drug Addiction and Treatment in Madison, Wisconsin

Madison is the capital city of Wisconsin and center of the Madison Metropolitan Statistical Area. With a population just over 250,000, Madison is a vibrant and bustling city surrounded by Dane County, Iowa, Green, and Columbia counties. Madison struggles with many of the same substance abuse and addiction problems currently faced by other American cities, including opioid medication abuse. Heroin abuse and addiction is also a significant problem in Madison and across Wisconsin, with legal and illegal opioids responsible for more drug overdoses than any other drug class. Drug related deaths accounted for 43 percent of all accidental deaths in Madison County in 2017, with this huge problem needing constant attention from policy makers and drug treatment professionals. If you know anyone in Madison who is living with a substance use disorder, it’s important to find specialized treatment as soon as you can. 

If you live in Madison, and have fallen victim to substance abuse don’t hesitate to seek treatment. There are enormous resources in at your disposal.
Credit: https://www.milwaukeemag.com/wisconsin-state-ban-butter/

Demographics and Crime in Madison

Madison has a predominant White population, who make-up roughly 79 percent of the city’s racial profile. African Americans represent 7.3 percent of the racial profile, with Asians accounting for 7.4 percent, 2.9 percent from other races, and Native Americans representing 0.4 percent. The median income in Madison is $31,659 per capita, which includes both adults and children. The median household income is $53,933, with roughly 5.8 percent of families and 15 percent of the entire population living below the poverty line. This includes 11.4 percent of people under the age of 18 and 4.5 percent of those aged 65 and over. Poverty is often linked to substance abuse, with people living below the poverty line often struggling to get the help they need in terms of rehab and other support services.

According to data from Neighborhood Scout, Madison has a crime index of 16 out of 100, meaning it is safer than 16 percent of US cities. There was a total of 8,157 crimes reported in Madison in 2017, including 7,316 property crimes and 841 violent crimes. There are 3.33 violent crimes taking place in Madison per 1,000 residents, compared to the Wisconsin state average of 3.06 and the national median of 4.00. Property crimes are higher in Madison than both the state and national average, however, at 28.97 crimes per 1,000 residents compared to 19.33 and 25.00 respectively. Property crimes are often related to substance abuse and addiction, with people robbing houses and cars as a way to fund their drug addiction.

The Opioid Epidemic in Madison

Madison continues to struggle with an opioid epidemic like many other American cities. Opioids are a highly addictive class of central nervous system (CNS) depressants that are capable of causing physical and psychological dependence and overdose. While the street drug heroin is widely associated with crime and overdose deaths, prescription opioids such as hydrocodone and fentanyl are also causing major problems throughout the community. Opioid addiction requires professional medical detox and rehab treatment, with a range of facilities located throughout Madison and across the state of Wisconsin. 

According to the 2014 National Survey on Drug Use and Health, there are an estimated 6,600 regular heroin users currently living in Wisconsin. Almost half of all people addicted to heroin are also addicted to opioid medications, with a growing number of people developing problems with prescription drugs in isolation. Overdose deaths are the biggest concern for policy makers and drug treatment professionals, with street heroin and prescription opioids often mixed in a dangerous combination. According to the Madison County Coroner’s Office, 87 people in Madison died from drug abuse in 2017, with most deaths attributed to opioid drugs.

What is a substance use disorder?

A substance use disorder is a medical condition defined by the problematic use of psychoactive substances. Also known as a drug use disorder, this condition is closely related to drug addiction and dependence. Substance use disorders affect people from all walks of life, from binge drinking and prescription drug misuse through to heroin and cocaine addiction. While the exact definitions of substance abuse and substance dependence are not clear, what we do know is that problematic drug use is a huge and growing problem in modern society. People who are living with drug problems regularly face physical health problems, psychological problems, social problems, and legal problems. Professional help is often needed to help break the bonds of abuse and addiction, with detox and rehab facilities located throughout Wisconsin and across the United States.

What are signs and symptoms of a substance use disorder?

The official definition of a substance use disorder revolves around the problematic and compulsive use of psychoactive substances. Generally speaking, someone can be said to be living with a substance use disorder whenever particular substances are causing problems in their life and they continue to use those substances. While these disorders are often accompanied by dependence and addiction, this is not necessarily the case. For example, someone can have a problem with binge drinking and not be dependent or addicted to alcohol. It’s also possible for someone to be physically dependent on legitimate medications without having a substance use disorder, which also requires compulsive or impulsive use patterns. While dependence and addiction are not enough to define a substance use disorder, it’s important to understand the differences between these terms before starting any kind of treatment plan.

Physical vs Psychological Dependence

Physical drug dependence is recognized by the experience of specific physical-somatic withdrawal symptoms when drug use is stopped. Substances known to cause physical dependence include alcohol, heroin, prescription opioids such as oxycodone and fentanyl, and prescription sedatives such as Xanax and Klonopin. Physical withdrawal symptoms can be dangerous and even deadly if they are not treated properly, with people always advised to seek professional treatment as soon as they can. A medical detox period is typically used to help manage these symptoms before they get out of hand and create additional problems.

Psychological dependence involves the experience of emotional and motivational withdrawal symptoms instead of physical ones. For example, someone who abuses cocaine or marijuana on a regular basis may experience things like anxiety and lack of motivation when drug use is stopped. While these symptoms are not physical in nature or life threatening, they can create serious psychological problems and lead to relapse if left untreated. Medical detox is not normally used for psychological dependencies, which are instead treated through behavioral therapy and other forms of psychotherapy. It’s important to note that drug addiction is not the same as drug dependence, with addiction recognized by compulsive drug taking patterns rather than the existence of specific withdrawal symptoms.

What is the difference between physical and psychological addiction?

Prescription Drug Abuse and Dependence

Prescription drug abuse is a huge and growing problem in American society. There are three classes of prescription drugs that are regularly abused: opioid painkillers, benzodiazepine sedatives, and stimulants. These drugs all have different effects and require unique treatment programs. Opioids are the most widely abused type of prescription drug; including naturally occurring opiates such as codeine, thebaine, and morphine; and semi-synthetic derivatives such as hydrocodone, oxycodone, and fentanyl among others. Opioids are highly addictive and can cause death through overdose. Benzodiazepines include drugs such as Klonopin, Xanax, and Valium among others. These substances are also known to produce dependence and addiction, with detox and rehab needed to break the bonds of addiction. While stimulants do not produce distinct physical withdrawal symptoms like the other two drug classes, they can still cause significant emotional and psychological problems. Treatment for prescription drug abuse is available in Madison and across the state of Wisconsin. 

How to Recognize Drug Problems

People often go to extreme lengths to hide their drug abuse from friends and family members. This makes it difficult to diagnose and assess problems properly, with people often needing to hit rock bottom before they are ready to accept help. If you’re worried about problematic drug use by someone you love, however, there are some warning signs to look out for. While these signs are not applicable for all cases, they can shine a much needed light on some problematic behavior patterns.

  • mood swings
  • lack of motivation
  • financial problems
  • health problems
  • legal problems
  • inability to stop drug use
  • tolerance
  • altered sleeping patterns
  • altered eating patterns
  • not meeting work, school, or family responsibilities

How can families and friends help someone needing treatment?

Drug Treatment Intake and Assessment

Before entering a treatment program, people need to go through a comprehensive intake and assessment procedure. A number of physical and psychological factors can influence treatment, with clinicians needing to assess each patient to make sure they get the help they need. During the initial intake, practitioners will attempt to identify any issues that might impede or complicate the treatment process. Along with identifying the severity and history of addiction, clinicians will also attempt to identify high-risk individuals, mental health conditions, and any other life issues that may affect treatment. External factors known to affect treatment include behavioral addictions, co-occurring disorders, criminal issues, domestic and family abuse, and homelessness.

Prioritization is a key concern for practitioners during the early stages of intake. While lots of people can benefit from drug addiction treatment, some people need help faster than others. The need to access treatment depends on many factors, including the existence of dependent children, justice system of legal issues, homelessness, intellectual disabilities, life-threatening medical conditions, co-occurring disorders including eating disorders, and mental health disorders. Clinicians will attempt to provide an accurate treatment pathway for each patient based on their needs. During assessment, patients will be asked lots of questions about their drug addiction, including their expectations regarding treatment and aftercare. The risk of relapse may also be identified at this early stage, along with any other issues of experiences that may affect the treatment process.

Detoxification

Detox, also known as medical detox, is the process and experience of drug or alcohol withdrawal under medical supervision. Medical detox is essential to many treatment programs, especially when physical drug dependencies have been identified. Detox is often treated as a three stage process, with an initial evaluation phase followed by medication and consultation. While it is possible to go through detox without the use of medications, rapid “cold turkey” detox programs can be dangerous and are often ineffective.

Detox Evaluation

During the evaluation phase, clinicians will take detailed blood tests in an attempt to identify any circulating psychoactive substances. This is necessary because recreational drugs can often cause dangerous interactions when combined with detox medications. For example, a heroin addict may still have heroin in their system when they enter detox, which may interfere with the prescription of methadone or other opioid replacement medications. Along with detailed blood tests, practitioners will also attempt to identify mental health problems and co-occurring disorders such as behavioral addictions and eating disorders.

Detox Stabilization

The second phase of detox is designed primarily to stabilize the patient prior to rehabilitation. While medications are often used in this context, it may be possible to stabilize someone with drug discontinuation alone. The medications used depend on the patient, the extent of addiction, the drug of addiction, and how they are likely to react with the treatment. Generally speaking, people are prescribed central nervous system (CNS) depressants such as Valium in order to help manage withdrawal symptoms and reduce the risk of medical complications.

Detox Consultation

The third phase of detox involves a detailed consultation process that helps the patient to identify potential rehabilitation options and find the help they need. While medical detox is needed to help manage withdrawal symptoms and reduce the risks associated with drug discontinuation, it does very little to address the underlying problem of addiction. Once the patient is stable and drug free, clinicians will guide them towards a residential or outpatient program that helps them to address these issues.      

What is withdrawal? How long does it last?

Rehabilitation

Rehabilitation is the cornerstone of drug treatment, with a range of individual programs applied to help people turn their lives around. Drug rehab programs are available throughout Madison and across the United States, from informal outpatient programs through to intensive residential regimes. Rehab can help people with a wide spectrum of substance use disorders, from legal drugs like alcohol through to prescription opioids and street drugs. While medication treatment is available in some rehab centers, most programs are dedicated to psychotherapeutic routines. Common treatment paradigms used during rehab include cognitive behavioral therapy, contingency management, motivational therapy, family therapy, and traditional 12-step support groups. Access to individual programs depends on the treatment center in question, with some rehab clinics offering programs that adhere to the disease model of addiction and others using programs based on the free will model of addiction.

Medication Therapy

Long-term medication therapy, including opiate replacement therapy, is available from many rehab treatment centers. While pharmacotherapy measures do very little to address the emotional and cognitive reasons for drug addiction, they can still prove very useful. Medication therapy is mostly applied when physical drug dependencies have been identified, including alcoholism, heroin addiction, and prescription opioid addiction. When treating alcoholism, benzodiazepine drugs such as Valium may be prescribed, with disulfiram and topiramate also used in some situations. During opiate replacement therapy, patients will typically be given methadone or buprenorphine as a form of harm reduction and addiction management. It’s important to note, however, that this form of therapy does nothing to address the psychological issues that underpin addiction. Pharmacotherapy routines should always be accompanied by psychotherapy.

Behavioral Therapy

Behavioral therapy, counseling and other forms of psychotherapy form the basis of most rehab programs. Whether applied in a group or individual setting, counseling is designed to help people change problematic behavior patterns from the inside-out. There are many ways to address effective counseling and lots of different treatment paradigms that can be used. Generally speaking, counselors attempt to identify emotional and cognitive distortions in order to prevent unwanted compulsive actions such as drug taking. While it is possible to perform this hard work on yourself, access to professional therapists is essential for anyone who wants to get clean quickly and avoid relapse. Because drug addiction is based on reinforcement and actual brain changes, addicts need to set up new associations before they can create healthy behavior patterns.

12-step Support Groups

Conventional 12-step support groups form the basis of many drug rehab programs, including Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). This treatment model is based on the disease model of addiction, which claims that substance use disorders are a lifelong disease that depend on constant management. While this form of treatment is not ideal for everyone, it has proved useful for some substance use disorders. 12-step programs are also prevalent in the context of aftercare, with some patients attending meetings for months, years, or even on an indefinite basis.

Relapse Prevention

Relapse, also known as recidivism, describes a return to problematic drug use following a period of prolonged abstinence. Dedicated prevention strategies can be applied at any stage of drug rehab, with some systems using relapse prevention programs during continuing care to cut down relapse rates. Relapse prevention is a cognitive behavioral approach to addiction treatment that helps people to identify potential triggers and set up different response patterns that don’t rely on unwanted drug taking behavior. Clinicians will help people with self-efficacy, positive outcome expectancies, causality, and decision making processes. By learning how to identify risky situations before they take place and cope with situations more effectively, recovering addicts can avoid making the same mistakes time and time again.

Mindfulness and meditation can be used as an effective relapse prevention tool. By learning emotional regulation, trigger recognition, and positive reinforcement, recovering addicts can learn more about the very mechanisms that lead to unwanted behavior patterns. Mindfulness programs can be based on eastern meditation, acceptance and commitment therapy (ACT) or a number of other approaches. Research has indicated a number of positive effects from mindfulness programs, which have proved effective for substances such as nicotine, alcohol, cocaine, amphetamines, and opiates among others.

Continuing Care

Also known as aftercare, continuing care is important in the contest of long-term recovery. While detox helps people to withdrawal from harmful substances safely and rehab helps them to address the psychological aspects of addiction, these measures are not enough by themselves. In order to prevent relapse and promote sustainable life-long changes, aftercare is also important. Common aftercare programs include Alcoholics Anonymous and other 12-step groups, individual and group counseling, family therapy, moral reconation therapy, and ongoing behavioral therapy.

Sober Living Environments

Sober living houses may also play a crucial role during aftercare, with these specialized accommodation centers able to help people make the difficult transition from treatment back to everyday life. Also known as sober living environments or sober living centers, these facilities allow people to start fresh in a safe and supportive environment. Sober living centers generally operate under a strict set of guideline and rules, with people needing to abide by these rules at all times in order to receive accommodation and ongoing treatment. Common rules include:

  • sobriety at all times
  • random drug and alcohol testing
  • no overnight guests
  • no violence
  • on-time payment of fees
  • respect to staff and house guests

If you know anyone in Madison or elsewhere who is struggling with a substance use disorder, it’s important to reach out to a specialized treatment facility as soon as possible. 

What happens after discharge?

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