Paths to Drug Addiction Treatment
Do You See the Signs?
When failing school seems like a minor problem, because the sheriff is at your door again, looking for your son. When coming home late starts to look like not such a bad thing, because your daughter is in the emergency room, struggling for every breath.
The frustration is unimaginable. The pain is unbearable. And the fear of what’s ahead is off the charts.
“I watched a beautiful child grow from a sweet innocent bundle of joy to a mischievous little boy, doing all the things little boys do. Never in my wildest dreams did I ever think that one day a horrible disease would strike this child and turn him into a monster.”
Kathleen Larsen-Dobbs, A Mother’s Love and Hate for Her Addicted Son, 2009
When everything about your child’s life seems to be careening out of control and headed for the edge of a steep cliff and down into an abyss so deep you can’t see the bottom, can you see the signs…the signs of substance abuse? They are all you need to see to know some kind of treatment has become more than a must...they point to a matter of life and death.
Denial: “I don’t have a problem, you’re the problem.”
Tolerance: “I have to drink that much to get my buzz.”
Craving: “All I ever think about any more is getting high.”
Loss of Control: “I can stop whenever I want.”
Abject Apathy: “I don’t care. Let ‘em fire me.”
Helplessness: “Nothing I do works.”
Withdrawl: “I want to die. Please, just let me die.”
And what about re-current nausea, profuse sweating, constant shakiness, and extreme anxiety?
These are the signs of substance abuse. Although they do not all have to be present, any one of them alone is cause for concern. But the good news is, help is only a phone call away.1
"The path to addiction begins with the voluntary act of taking drugs. But, over time, a person's ability to choose not to becomes compromised."
National Insitute of Drug Abuse (NIDA)
It’s Not Just Your Child
Substance abuse is a national problem. It affects people of all ages, both genders, all socio-economic statuses, all races, and all ethnicities. And it’s causes come from a wide variety of sources, including genetics, environment, psychological traits and stress...sometimes more than one.
The rate of teen drug overdose deaths in the United States climbed 19% from 2014 to 2015, from 3.1 deaths per 100,000 teens to 3.7 per 100,000, according to data released this week.2 The new numbers involve teens ages 15 to 19 and were released by the National Center for Health Statistics.
According to recent statistics released by the Centers for Disease Control, 4,300 deaths occur in underage youth every year due to excessive drinking. 11 percent of all alcohol consumed is by 12-20 year-olds, with 90 percent being attributed to binge drinking. 1 in 5 teens ride in cars where the driver has consumed alcohol.2
“Alcohol is the substance of choice for teens.”
Treatment programs and strategic therapies, provided by trained, certified and licensed caregivers, are available to help your child turn the recovery corner, and get him or her back on the road to a healthy life. Wrap-around services for the whole child, involving doctors and nurses, psychologists and psychiatrists, counselors and therapists, and social workers, are totally equipped and capable of bringing back the reality of the son or daughter you once knew.
More about this later, but if you cannot wait because your child's life depends on it, please call the U.S.'s official National Helpline at 1-800-662-HELP now.
“People with alcohol and drug dependence problems can and do recover.”
Treatment Program Stuff You Need to Know
Whatever the kind of treatment program (basic inpatient to intensive outpatient) you are considering, please know that research-based effective programs3 must do most, if not all, of the following:
1. Work with the understanding that addiction is complex, and yet it is treatable.
2. Work with a conviction that no single treatment is right for everyone.
3. Ensure that all therapies are quick and easy to access.
4. Make sure that all needs are met, not just drug abuse.
5. Make sure the treatment is long enough to do the job.
6. Include a more than a suitable variety of effective therapies.
7. Believe that medication is as important as treatment.
8. Review and modify treatment plans as frequently as needed.
9. Ensure treatment addresses other possible disorders as well.
10. Stipulate that detox is only the first step to treatment
11. Believe that treatment does not have to be voluntary to be effective.
12. Adhere to strict and ongoing drug-use monitoring.
13. Test for HIV/AIDS, HEPs B and C, Tuberculosis, and other infectious diseases.
14. And provide more than ample wrap-around services for every need.
"Addiction treatment must help a person ultimately stop using drugs, stay drug-free, and be productive in a family, work, and society."
National Institute on Drug Abuse
Service components3 of any decent substance abuse treatment program strives to help with the following needs areas:
- vocational--current and future job provisions and considerations
- financial--bill payment, present, and future, especially w/re to treatment costs
- transportation--upcoming options for car, bus or even bike mobility
- mental health--making sure all "disorder" stones are being turned over
- medical--doctor referrals, hospitalization and pharmaceutical needs
- educational--everything you must know and be able to do after recovery
- HIV/AIDS--must be ruled out and/or dealt with
- housing--temporary and long-term needs and options
- legal--representation needed, and pending litigation matters
- family and friends--relationship repair and social reintegration
- childcare--making sure someone qualified is minding the loves
- nutritional --current and future nutritional lifestyle considerations
"Drug abuse treatment plans must not only help addicts detoxify in a safe environment, but also assist patients through all stages of the recovery process."
Eric Patterson, DrugAbuse.com
Most all substance abuse treatment programs follow a similar protocol1:
a. Clinical Assessment and Physician Referral--have to know what is being dealt with
b. Detoxification and Withdrawl Watch--a pre-treatment requirement
c. Identification of Medical Needs--doctor decision of how to help
d. Development of Treatment Plan--multi-agency necessity
e. Provision of Education and Therapy--delivery responsibilities
f. Modifications of Plan as Needed Along the Way--flexibility premium
g. Social Detoxification--relationship repair and community reintegration
h. Recovery--continued improvement plans and maintenance needs
Typical treatment plans include4 the following as a written guide for combatting addiction:
- treatment goals--what's the ultimate endgame?
- treatment therapies--activities most needed?
- educational objectives--what is a must to know and do?
- treatment timeline--milestones and proposed end-date?
- service provisions--what life areas need to be focused on?
- participating personnel--who has to be involved?
- needed facilities--where will it all happen?
- required resources--fund assistance, materials, supplies, etc.?
And the careful implementation of treatment plans must include regular and un-scheduled progress checks, and a willingness to make whatever adjustments are needed along the way.
"...effective treatment programs do exist, but far too few people...receive the help they need."
Substance Abuse and Mental Health Services Administration (SAMHSA)
There are two basic types of treatment programs (inpatient and outpatient), but a lot of very important lee-way inbetween1.
Inpatient/Residential Center Treatment
full focus on recovery
provided in special units of hospitals or clinics, most often
offering both detox and rehab services
residing 24/7 in a therapeutic community, focusing on both
medical and mental health needs
typical 30-90 day duration of stay
can also be an extended stay of 9-12 months, depending on the
severity of need
may include recovery housing
Day Treatment/Partial Hospitalization
same as the inpatient, but not requiring full-time residential,
possibly due to the presence of more stable home life
typically spending set hours at hospital or clinic each day
Basic Outpatient Treatment
living at home, but participates in a program on a regular,
but more limited basis (i.e., 2-3 days a week)
participates in treatment several hours on any given day as assigned
offers both detox and rehab services, and focuses on medical
and mental health needs
typical 3-9 month assignment to program
Intensive Outpatient Treatment
same as an outpatient, but extended participation required
typical 9-12 month program assignment, with extra time at the front
end of detox
can also be a short stay (90 days), depending on the severity of need
medication assistance on an outpatient basis (i.e., methadone)
"...there is no finite treatment that will work for everyone."
National Insitute of Drug Abuse (NIDA)
Therapies for Combatting Substance Abuse
In every reputable substance abuse treatment program, the therapies employed therein must successfully modify attitudes and behaviors, increase the knowledge of and propensity for living a healthy lifestyle, and persist harmoniously with other therapies, including medication3.
"It is essential that treatment is tailored to the unique individual."
National Institute on Drug Abuse (NIDA)
The process by which the removal of toxic chemicals (alcohol/drugs/nicotine) that have accumulated in the body are removed. This is accomplished most often in a center that provides support to safely deal with the physical symptoms of withdrawal. Most such centers also provide counseling and other therapeutic activities to help with the psychological consequences that result. Depending on the severity of the substance abuse/addiction circumstances, a medical "detox" may be necessary, under the care of medical professionals.
Individual Cognitive-Behavioral Counseling
A therapeutic approach to helping individuals with a range of disorders, including eating, anxiety, depression, obsessive compulsion, post-traumatic stress and anger problems. it is a form of psychotherapy that encourages patients to challenge their distorted thoughts, emotions and behaviors that are destructive to their well-being and replace them with healthier, more socially appropriate ones.
Group Cognitive-Behavioral Counseling
The same function as the one-on-one version, but with groups of individuals suffering from the same disordered thoughts, emotions, and behaviors. The power of the group process helps individuals hone communication and socialization skills, and learn to better accept their shortcomings in a peer-based setting. Group-based therapy allows individuals the chance to develop self-awareness by listening to others with similar issues.
Multi-dimensional Family Therapy
A science-based treatment for individuals with substance addiction and resulting behavioral problems that compromise the well-being of the individual's family. As an option to forgo out-of-home placement, or to prepare a patient for return back home from treatment, MDFT helps the entire family focus on their relationships with one another, their interactions, and the undue influences they have on one another.
Therapeutic Community Therapy
Therapeutic communities are common in long-term residential treatment programs, involving self-supporting and correcting groups in a democratically-based social atmosphere. While the power in this kind of community rests primarily with peers, they are guided by medically trained professionals to move in positive directions for both the individuals and the group as a whole.
With having knowledge of what addicts are up against physically, socially and psychologically, comes great understanding. In possession of skills to help cope and to make positive decisions, comes great power. Seeing their problem for what it actually is, allows individuals to not only understand it clearly but to also form effective strategies and rationales for changing what's getting in their way of success. Good old reading, writing, listening, thinking, and speaking end up being tools individuals can use to take control of both their addictions and their lives.
Medical Assisted Therapy
Medically-Assisted Therapy, or MAT, is a medication-assisted option that combines behavioral therapy and medication to treat substance abuse. It is FDA approved and used in combination with counseling, it provides a "whole patient" approach to treatment. This approach is not only a medicinal approach but also makes use of medical devices like the NSS-2Bridge, which involves electronic stimulated responses.
Motivational Interviewing/Dialectical-Behavioral/Motivationally Enhanced Therapy
This transactional/dialectical approach to counseling is directive and client-centered and is designed to elicit behavior modification by "talking it out" in a Q and A format. This technique has been particularly successful with individuals who are unmotivated to deal with their addiction, or who do not think they have a problem in that area.
Outpatient/Aftercare/12-Step and Non-12-Step Programs
Examples of this kind of therapy, typically used for outpatient and aftercare situations, are Alcoholics Anonymous, Narcotics Anonymous, Cocaine Anonymous, Heroin Anonymous and Crystal Meth Anonymous. The idea of long-term participation programs like these is to provide structure, support, and guidance after emergency detoxification and intensive therapy.
More and more counselors now rely on wilderness or adventure therapy, along with cognitive-behavior counseling, to help their patients turn their lives around. Instead of a couch in a dimly-lit room, individuals deal with the same issues that are troubling them, but instead while they are hiking or camping.
Alumni/Success Story Therapy
What better way to learn about the road ahead or how to work out your issues in life than by listening and talking to those who have gone before you. Testimonials, written or recorded or spoken in person, have the power to open the eyes of individuals who are struggling to see how they could go.
Treatment programs that offer unique approaches to the norm, including Acupuncture, Yoga, Stretching, Breathwork, Meditation and Nutritional Interventions. This approach integrates more traditional therapies in an alternative framework, which may include art, experiential activities, recreation, music or even writing.
Faith-based rehab centers do all the same things as conventional or secular centers but within a context of your same spiritual core values. Instead of a community-based approach, fellowship with other like-minded believers is the norm.
Tai Chi Therapy
Imagine getting into the boxing ring of substance addiction and "Chinese shadow boxing" with your personal and social demons. Tai Chi is a gentle form of martial art that involves harmonizing your thoughts, behaviors, and emotions to channel a healthy energy flow around and through your body. It is a controversial approach to the approaches of Western thought, but who can argue with a means of teaching a struggling individual to harness the essential forces of the universe.
Help is Only a Phone Call Away
Calling a reputable helpline for substance abuse treatment is the first best step toward recovery, but, "who ya gonna call?" Not Ghost Busters, that's for sure. How about those who literally know it all when it comes to fighting substance abuse?
"Choosing professional help is the first step to reclaiming your life."
How about the nations' "hotline" for help with substance addiction1. It is the agency within the U.S. Department of Health and Human Services. Its mission is to reduce the negative impact of substance abuse and mental illness in America's communities.
Call SAMHSA's National Helpline, 1-800-662-HELP. It's free. It's confidential. It's on call 24/7, 365. It's available in both Spanish and English. It's for individuals and families. And they can refer you to get the help you need locally. SAMHSA works closely with other health agencies across the country in order to help make sure as many responders as possible are on the "same page."
The Substance Abuse and Mental Health Services Administration, or SAMHSA, is a treatment referral routing service, available to anyone and everyone. All you have to do is call. You can also connect with SAMHSA through social media, including Facebook, Twitter, the SAMHSA blog and YouTube.
DRUG AND ALCOHOL REHAB/TREATMENT REFERRAL SERVICE
Another reputable helpline to consider is 1-800-662-HELP, the Drug, and Alcohol Hotline for Rehab/Treatment Referral Service. This contact, like all the others listed below, are free, available 24/7, and confidential.
TOP SUBSTANCE SPECIFIC HELPLINES ONLINE
Search for specific helplines: Al-Anon for Teens, Rehab for Alcoholism, National Cocaine Hotline, National Heroin Hotline, National Marijuana Hotline, and National Quit-Smoking Hotline.
Help is only a call away, but you have to make the call. Helplines are vital, but they have to be called. They can be reassuring, they can be calming, they can be clarifying, they can be supporting...they can be many helpful things, but nothing good can happen if you don't pick up the phone.
"Help is almost impossible to come by if you don't ask for it."
Mindful Thoughts on Substance Abuse Treatment
Two of the most powerful drives of human nature is to seek pleasure and avoid pain. Can the answer to treating substance abuse reside in those two basic truths? Researchers at UC Berkely's Greater Good Science Center think so. They believe the approach of "Mindfulness" might be the best 'stopper' of substance abuse. It may well be that the lack of consistent success of more traditional approaches to substance abuse treatment is because these two truths are largely ignored5.
"About half of the substance abusers who enter treatment use again within a year."
National Survey on Drug Use and Health
If substance use and abuse are viewed as the result of a human's drive to embrace pleasure and steer clear of pain, the solution to treatment may actually be more simple than once thought. Instead of focusing on avoiding or learning to control use-triggers, which result in negative emotions or craving, what if individuals focused on cultivating a moment-to-moment, non-judgemental awareness of their thoughts, feelings, and surroundings with respect to potential pleasure and pain stimuli?8
University of Washington researcher, Sarah Bowen, contends that this approach, which they call Mindfulness-Based Relapse Prevention, done in combination with sitting meditation, helps individuals learn to name and tolerate craving and negative emotions, rather than fighting or avoiding them. In short, the idea of this approach is to choose to engage with the problem at hand in a positive manner, rather than a negative one.
"...they're developing a tool to become aware of that inclination to want only pleasurable things and escape uncomfortable things,"
The strategy, says Bowen, is to help individuals recognize their discomforts when they arise, observe them with a presence and compassion, and thereby take the power away from the natural inclination to reach for something to make the craving go away, essentially avoiding the tendency to avoid the pain by any means necessary. Awareness of our experiencing and the ability to relate to that experience in a more positive regard gives individuals more freedom to choose how to respond to discomfort or fear. No longer do our default modes of response rule the roost.
National Helpline, Substance Abuse and Mental Health Services Administration, 2017.
National Center for Health Statistics, 2016.
Treatment Approaches for Drug Addiction, National Institute for Drug Abuse, 2018.
Treatment Plan, Good Therapy, 2017
Can Mindfulness Help Stop Substance Abuse, Emily Nauman, and Sarah Bowen, Greater Good Magazine, 2014.