Rehab 101, Article 4: Treatment

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Introduction
Treatment solutions are personal. This is because every person’s brain chemistry and physiology are different. Apart from the differences in substance tolerance, there are other issues to contend with including environmental, familial, genetic, and psychological (Cause).

Over a century of research has led to modern multi-disciplinary treatment methods that are both personalized for every individual as well as providing a group or social setting that is aimed at introducing the individual back into society.

This approach tends to deal with the addict from a holistic point of view rather the just treat the addiction from a chemical stance. While detoxification is the first mutant step to take, it does not cure the addict, it only removes the chemicals from the body, but does not free the mind from the triggers and dependency. Rehabilitation centers provide a closed environment to help the addict recover from the detoxification as well as learn about themselves and how to interact with others. This too is not a full treatment; it is a stage in the process.

Treatment is, in fact, a lifetime process, it is ongoing, and requires dedication to cause and focus on handling life, meeting situations head on and not running away from stress. For more information on Treatment you can also visit Ayahuasca

Treatment has been separated into four core groups:

  • Medication
  • Behavioral
  • Experimental
  • Residential

While presented as separate categories, they are performed together and occur at the same time. Therefore, rehab is, in fact, a part of the treatment process and not a separate issue.
Medication treatment is when the multi-disciplinary team uses medications to combat substance abuse. These medications include the use of opioids such as methadone and buprenorphine. Methadone and buprenorphine are used as maintenance therapies to reduce cravings for opiates. The concept is that they will reduce illegal drug use through harm reduction. Both of these drugs are used as maintenance medications or used as detoxification aids. Current research has shown that maintaining use of Methadone and buprenorphine eliminates the dependency on injection drug usage. The National Institute on Drug Abuse (NIDA) presented findings that “patients stabilized on adequate, sustained doses of methadone or buprenorphine can keep their jobs, avoid crime and violence, and reduce their exposure to HIV and Hepatitis C by stopping or reducing injection drug use and drug-related high-risk sexual behavior.” Source: Mattick RP; Digiusto E; Doran CM; O’Brien S; Shanahan M; Kimber J; Henderson N; Breen C; Shearer J; Gates J; Shakeshaft A; NEPOD Trial Investigators (2004). National Evaluation of Pharmacotherapies for Opioid Dependence (NEPOD): Report of Results and Recommendations (PDF). National Drug and Alcohol Research Centre, Sydney. Commonwealth of Australia.
Another medication that NIDA suggests is Naltrexone, which is a long-acting opioid that is used to treat alcoholism and opiates but is less effective then Methadone and buprenorphine.

Smoking (nicotine) addicts have been countered by antidepressants bupropion and nortriptyline. “Bupropion inhibits the reuptake of norepinephrine and dopamine and has been FDA approved for smoking cessation, while nortriptyline is a tricyclic antidepressant which has been used to aid in smoking cessation though it has not been FDA approved for this indication.” Source: Klein, Jared Wilson (July 2016). “Pharmacotherapy for Substance Use Disorders.” Medical Clinics of North America. 100 (4): 891–910.

Rather than go into more detail over the many medication treatment factors available I will state that drugs are used to fight drugs. Where one dependency is removed using a replacement drug, which is slowly reduced over time. However, medication is only one form of treatment, in fact, medication treats the symptoms it does not treat the cause, and this is why a multi-disciplinary approach is taken.

Behavioral Therapy has four approaches:
Motivational interviewing. This is an initial stage which is used to help the addict confront his/her past and to find the root cause. During the process build motivation to continue rehab and fight the addiction.

  • Cognitive-behavioral therapy. This form of therapy is used to help addicts recognize the situation that led to the substance taken, and to cope and avoid similar situations that could trigger a relapse.
  • Motivational incentives. This is part of the individual and group therapy process, where incentives are given to overwrite triggers that would drive the addict back into relapse.
  • Multidimensional family therapy. This is a post-rehab support therapy where the family is trained to cope with and assist the addict in the performance of daily life, and improving the family unity.
  • Behavioral therapy is another facet of the entire treatment process, and starts during detox continuing through residential rehab and well after into post-residential into the home and workplace. Research has shown that most addicts require at least 3 months of behavioral therapy before they can maintain their status with counseling.

Residential treatment
This is the term used for inpatient rehab centers. It covers the time the addicts are in the facility and lasts for around 30-90 days depending on the severity of the addicts status. Most patients require 30 days to recover to post-residential maintenance.

Experimental treatment
There are always innovative measures being developed, in medication, behavioral and natural or alternative sciences. Sometimes patients will be offered a chance to take part in such an experiment before they agree, they should research properly and get second and third medical professional opinions.

Treatment Intensity
Usually in the first week, immediately after detox, treatment is intense. Multiple sessions of both individual and group therapies are combined with medication when relevant. The residential environments include therapeutic communities, residential rehab centers, and recovery houses. Addicts will find themselves in one of these environments depending on the severity of their case and with a preference for in-house treatment rather than outpatient rehab.

Therapeutic communities are for longer periods than the standard 30-day deals. These are structured environments that provide a full living style for between 6 to 12 months.

Recovery housing is for post-rehab patients that do not wish to return home immediately or do not have a home to return to and are used to help them find employment and get bac onto their own feet.