Alcohol, illegal drugs, prescription drugs, and other harmful substances are being abused by thousands of people as you read this right now. They are being abused by people from all walks of life, no matter their age, ethnicity, social status or anything else. Some people are using them recreationally while others are still hooked years after they took their first drink, had their first heroin high, or snorted their first line of cocaine.
Some have tried to get clean and went back to using; others may not have even tried because they couldn’t afford addiction treatment or didn’t know where to get help. Some of them may feel they don’t even want help.
In 2015, an estimated 27.1 million people aged 12 and older were illicit drug users, according to the 2015 National Survey on Drug Use and Health. While using drugs and alcohol does not necessarily mean one will develop an addiction to them, regular use or recreational use increases that possibility.
Addiction is claiming lives at alarming rates unseen before in modern-day U.S. history. Consider that:
In March 2018, the U.S. Centers for Disease Control and Prevention (CDC) reported that nearly 64,000 Americans died from drug overdoses in 2016, an increase of almost 22 percent from 2015 reports.
“No area of the United States is exempt from this epidemic – we all know a friend, family member, or loved one devastated by opioids,” said Anne Schuchat, M.D., the CDC’s principal deputy director, reports ABC News.
It’s clear addiction isn’t going away.
Addiction is treatable, though in many cases, it will not be curable. Recognizing the signs of addiction is important to seeking help to treat it.
If you are interested in addiction treatment, our guide can help you through as you consider this important decision.
There are many stigmas and stereotypes about substance addiction. These can be harmful as they deter many people from seeking help for substance use that has reached the point of dependence or addiction.
Scientific study about addiction has evolved over time and is still being studied today. Having an addiction was once linked to having a moral defect of character or a lack of a commitment to follow through to end the abuse of substances. Scientists and researchers now focus more on the brain’s response to addiction and the behavior that results from chronic use of addictive substances.
In its short definition, the American Society of Addiction Medicine characterizes addiction as “the primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestation. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.”
The National Institute on Drug Abuse (NIDA) also has weighed in on defining addiction, writing that the condition is “a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. It is considered a brain disease because drugs change the brain; they change its structure and how it works. These brain changes can be long-lasting and can lead to many harmful, often self-destructive, behaviors.”
The institute also writes, “Addiction occurs when a person cannot control the impulse to use drugs even when there are negative consequences—the defining characteristic of addiction.”
There are other views that dispute the assertion that addiction is a brain disease. One perspective is that addiction is not a disease of the brain but instead, a series of repeated habits that change how the brain works.
Regardless of the debate about whether addiction is or is not a brain disease, there is general agreement that views that do not promote education and understanding about addictive disorders, and only promote addiction stigma, are barriers to treatment for people with addiction who are seeking recovery or are thinking about seeking recovery.
It is difficult to pinpoint one specific cause of addiction. That’s because many factors play a role in who becomes addicted and why. Not everyone who engages in recreational drug or alcohol use will develop an addiction to those substances. However, some will. There are a variety of risk factors involved including:
The U.S. National Library of Science writes that a genetic predisposition “results from specific genetic variations that are often inherited from a parent. These genetic changes contribute to the development of a disease but do not directly cause it. Some people with a predisposing genetic variation will never get the disease while others will, even within the same family.”
These can mean the difference between someone being more vulnerable to addictive substances than someone else.
Include stress, depression, anxiety, personality traits such as high impulsivity or risk-seeking, eating disorders, and other psychiatric disorders can make someone susceptible to addiction.
For example, exposure to physical, sexual, or emotional abuse or trauma, substance use or addiction in the family or among peers, access to an addictive substance; exposure to popular culture references that encourage substance use.
Many adolescents and teens, even young children, can abuse alcohol, nicotine or other drug use at a young age or early life stage.
The odds of developing an addiction are greater if one or more of these are present. But if they are, it still doesn’t mean one will become an addict. However, if there are more risk factors present, the chances are greater that a person will develop the disease.
There are many substances that can lead one into addiction. Some of the most common ones are often in the news and portrayed in movies and television shows. Among them are:
Depressant drugs “depress” the central nervous system and slow it down. Depressants affect functioning, performance, and mental health. Abusing depressants can bring on anxiety and depression. Excessive alcohol use can damage the kidneys and liver among other organs.
Alcohol, benzodiazepines (Xanax, Ativan, Klonopin), and cannabis are all depressants.
Stimulants are the opposite of depressants—they speed up the central nervous system and boost brain activity. They also affect the brain’s pleasure receptors by producing too much dopamine. As a result, users experience increased mental alertness and energy. Extended stimulant use eventually causes the brain to stop producing its own “feel-good chemicals” because it now relies on the drug to do that. The stimulants class of drugs is illegal and highly dangerous.
Cocaine, crystal meth, speed, and ecstasy (MDMA) are illegal stimulants.
Hallucinogens are drugs that cause users to have hallucinations, which are distortions in a person’s perceptions of reality. They are not addictive, but that makes them no less dangerous. Long-term or chronic hallucinogen use can cause psychosis, schizophrenia, and other mental health disorders.
LSD (D-lysergic acid diethylamide), peyote (mescaline), DMT (dimethyltryptamine), and ayahuasca are commonly used hallucinogens.
Dissociative drugs produce distortions in users sight and hearing. They also make users feel like they are floating and are detached from reality. NIDA writes, “Use of dissociative drugs can also cause anxiety, memory loss, and impaired motor function, including body tremors and numbness.”
PCP (phencyclidine), ketamine, salvia, and DXM (dextromethorphan) are commonly used drugs that cause hallucinogenic and dissociative effects.
Opioids are a class of prescription medications that are used to treat moderate-to-severe pain that results from surgeries or severe injuries. They are designed for short-term use. They are considered safe when taken as prescribed for a limited time. But despite that, many people abuse them and become addicted to their relaxing, euphoric effects, which can lead to death. According to the CDC, more than 115 Americans die of opioid overdoses.
Prescription pain relievers, such as OxyContin, Percocet, and Vicodin, as well as fentanyl, a synthetic opioid are in this class of drugs. Heroin, though it is derived from the poppy plant, which is naturally occurring, is also in this drug class.
Just recently, in March 2018, Florida Gov. Rick Scott signed a unanimously passed bill (HB 21), which aims to discourage and prevent patients from getting addicted to prescription pain relievers before turning to street drugs such as heroin and fentanyl. The measure also limits the number of prescriptions doctors can write for patients who need pain treatment to three days. Up to seven days’ worth could be prescribed if it’s found necessary.
Inhalant abuse occurs when users introduce chemicals into their bodies through “huffing,” or breathing in chemicals through the nose or mouth. Inhalants are huffed without the use of an external heat source. They are either compressed air or volatile substances (which refers to substances that are gaseous at room temperature). Huffing can also be called spraying (when inhaling compressed substances), sniffing, or bagging, which is based on the practice of placing substances in paper bags and inhaling.
Inhalants include amyl nitrate (poppers), nitrous oxide, toluene (a solvent used in paint thinners and other standard products), gasoline, propane, benzene, and methyl chloride. Because these household items are around and easily accessible, teenagers make up the majority of inhalant users.
The psychoactive drug cannabis, also known as marijuana, pot, and other names, is the most commonly used illegal drug in the U.S., according to the NIDA. The drug is made from the dried leaves, flowers, stems, and seeds from the Cannabis sativa or Cannabis indica plant. The chemical THC, or tetrahydrocannabinol, and other compounds alters its users senses, moods and causes impaired memory, judgment, and learning. Marijuana can be smoked, eating, or inhaled. People can also drink it. According to NIDA, the amount of THC in marijuana has increased over the years and become more harmful.
In 2015, more than 11 million young adults ages 18 to 25 used marijuana in the past year, according to the 2015 National Survey on Drug Use and Health. Despite the perception that regular marijuana is not as harmful as “harder” drugs, such as cocaine, heroin, and even alcohol, its abuse can lead to cannabis use disorder, as defined by the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5), which can, in turn, lead to addiction.
While addiction experiences vary according to the person, there are clues that signal when a person is battling a substance use disorder or addiction.
If you or someone you know has any of these signs, you may want to consider getting professional addiction treatment at a licensed, reputable drug or alcohol rehabilitation center.
Addiction treatment is the diverse behavioral therapies and pharmacological approaches used to help people stop seeking out and taking addictive substances that are harmful to them. There is a common belief that treatment only involves a chemical detox or a long, awful stay in a prison-like facility called rehab. Neither is true. A medical detox is just the start of drug treatment, which is a long and involved process, and “rehab” is only one kind of treatment. In many centers, it is a warm, friendly, and supportive community to people in recovery.
Treatment applies to just about any substance used and can take place in different settings for different time lengths. A great deal depends on the person who treatment is for. The programs and services that are determined for this person should address the individual’s physical, psychological, emotional, and social needs along with the addiction or substance use disorder and the kind of drug that was abused among other things.
Once active addiction is underway, it can be difficult for someone to stop using. Why? Because now the chronic use and abuse of addictive substances change the structure and function of the brain over time.
As a result, individuals will begin to show impaired judgment and decision-making, problems with learning, and problems with memory processes. In some cases, these conditions will become irreversible if the cycle of substance use continues.
The common addiction cycle that can quickly become frequent or chronic with repeated use often starts with experimental or recreational use. Some people will attempt to get off the merry-go-round but will find it challenging. These are the people who need help in breaking this cycle. Effective addiction treatment can help break these destructive patterns and offer a way out to health and well-being. Before addiction treatment can begin, one must first admit that using drugs, alcohol, or other addictive substances is a problem and that they need help in addressing it.
Treatment involves a series of steps before a person is placed in a setting for recovery. They are:
Before clients’ enter into any particular program at any facility, they are typically required to start their recovery journey with a medical detoxification (detox for short). This is a critical time in the recovery process, and for some people who have severe addictions and are in severe withdrawal, this is akin to addressing a medical emergency. In this stage of care, health care professionals monitor clients around-the-clock to ensure addictive substance(s) and toxins are removed from the body safely.
It also ensures clients will be treated as they manage withdrawal symptoms that start when the drug isn’t being used as much or disappears from the body’s system altogether as a result of the user not taking it anymore. A person does not have to wait for withdrawal symptoms to start or get fully underway before they seek medical detox help. This process can take anywhere from three to seven days or longer if needed.
Some substance users will try to avoid a professional detox and either try at-home remedies that may not be safe or they may go the “quitting cold turkey” route, which means they abruptly stop using the substance in hopes that their dependence or addiction will end. This is not recommended for many reasons.
Going cold turkey can do more harm than good. It can result in serious injury, relapse, overdose, or even death, especially in cases where clients are battling severe withdrawal symptoms. Withdrawals involving opiates, benzodiazepines, or alcohol are especially dangerous if quitting is done in this manner.
As mentioned earlier, detox is the first step of the treatment process, and it is designed to rid the body of toxic chemicals and help clients return to a place of stability. Addiction treatment specialists strongly recommended that recovering users enter an alcohol or drug rehab services at a licensed facility for long-term recovery.
Prospective clients meet with a health professional, such as a physician, nurse, psychiatrist, or a psychologist, who review them to see how they are doing. This meeting is called an assessment, and it is held to help the professionals get to know the clients they will be treating. The clinician asks clients questions concerning areas of their lives. Common questions that are asked at these meetings include:
Clients can expect to complete a physical examination to check the status of their health. A urine test is commonly given at the assessment and other tests to determine if other health problems are present.
After the assessment is finished, medical professionals will review the results of the tests and, based on those, recommend treatment options that are available to clients. They also will review what to expect during the treatment process. It is routine that clients and patients sign agreements about the expectations during this process.
Once a person has decided they need professional addiction treatment and recovery services, they will find the options are endless in figuring out what that treatment path looks like. Before that important decision is made, it’s important to first understand the treatment system and what is available to you or your loved one. The addiction treatment program types are:
This treatment program is low-to-medium in intensity. Outpatient clients commonly receive no more than nine hours of treatment a week at a specialty facility while continuing to live either at home or another place that is outside the center. This amount could be less for recovering teen users. Some centers offer evening or weekend outpatient services so people can continue to meet outside responsibilities such as work or school.
Clients receiving intensive outpatient care can attend between 10 hours and 20 hours of treatment a week at a center while living off-site. Like the outpatient setting, it is medium to high intensity and offers evening or weekend services so outside responsibilities can be met such as work or stay in school. People who require multiple services or have accompanying medical or psychological illnesses along with a substance use disorder may benefit from this setting. Individuals who need a higher level of care than outpatient treatment may also find an IOP to be a better fit.
Residential treatment provides a structured environment with medium-to-high intensity that lets clients fully focus on their recovery with 24-hour support. Addiction care and medical professionals are available 24 hours a day to help clients with their needs. These programs can run from a month to 12 months. The severity of someone’s addiction and other factors are reviewed before residential treatment is recommended. Residents go through different phases as they move through their program.
Partial hospitalization programs can be viewed as a bridge between residential and outpatient programs. In this medium-to-high-intensity setting, clients attend four to eight hours of treatment a daily, or 20 or more weekly, while continuing to live at home or another off-site facility, such as a sober home or transitional living home. Clients do not require 24-hour supervision or receive around-the-clock medical assistance like residential clients. They are, however, required to meet their weekly commitments and attend intensive therapy sessions. PHPs are an option for people with co-occurring mental disorders.
Inpatient treatment, known at some centers as residential treatment, is a high level of care. In this setting, clients receive detox and rehabilitation services for substance addiction in medical clinics or hospital units designed for these purposes. This setting is commonly chosen to treat people who have serious medical conditions or mental health disorders.
Medication-assisted treatment combines behavioral therapy and medications to treat substance use disorders, writes the Substance Abuse and Mental Health Services Administration (SAMHSA). Clients who have a physical dependence on primarily heroin and other opioids (or other drugs) may benefit from the MAT approach. Medical staff provides medication in a specialized outpatient setting in combination with counseling and other treatment services.
The National Institute on Drug Abuse offers insight into what makes treatment effective. It highlights that no single treatment is appropriate for everyone and that treatment varies according to the kind of drug used and clients’ characteristics. It also notes that treatment doesn’t have to be voluntary to be effective. Drug treatment interventions can be successful, even if they are ordered by a court, a job, or as an ultimatum from concerned loved ones.
“Matching treatment settings, interventions, and services to an individual’s particular problems and needs is critical to their ultimate success in returning to productive functioning in the family, workplace, and society,” it writes. Here are other factors that the agency says makes addiction treatment effective:
Time is critical when it comes to getting addiction treatment for the people who need it. The idea of going to a professional treatment center fills many addicted individuals with doubt, so it’s important that they have access to services when they are ready to get help.
This means it should address other needs in addition to the ones related to substance use. This includes any medical, psychological, social, vocational, and legal issues clients have, NIDA advises. Other factors such as age, gender, ethnicity, and cultures should also be considered.
It is common to use medication in treatment along with counseling and therapies for some clients, NIDA explains. People who are recovering from heroin addiction or opioid addiction may be given methadone, buprenorphine, and naltrexone to wean them off their dependence. Recovering alcohol users may be given acamprosate, disulfiram, and naltrexone for treating alcohol dependence.
Treatment programs should test for the presence infectious diseases and provide targeted risk-reduction counseling.
They also should connect clients to treatment if needed, NIDA advises. The agency goes on to say, “Typically, drug abuse treatment addresses some of the drug-related behaviors that put people at risk of infectious diseases. Targeted counseling focused on reducing infectious disease risk can help patients further reduce or avoid substance-related and other high-risk behaviors. Counseling can also help those who are already infected to manage their illness.” HIV/AIDS, hepatitis B and C, and tuberculosis are some of the health conditions that treatment should screen for when clients come into their care.
According to research cited by NIDA, recovering substance abusers need at least three months, or 90 days, in treatment “to significantly reduce or stop their drug use and that the best outcomes occur with longer durations of treatment.” Getting back on the path to health will not be a short process.
Treatment plans should be continually reviewed and changed as needed to fit the individuals’ current needs.
Clients often need different kinds of services and components combined during the course of their treatment, NIDA writes. For example, clients may need medication or medical services in addition to counseling or psychotherapy, NIDA explains. Continuing care ensures clients are getting their best shot at recovery.
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Treatment programs can be customized for each person. Most offer a combination of services to ensure the needs of the recovering person are met. Some of those services are:
While all of these factors and more play a significant role in addiction treatment and recovery, the client’s commitment and responsibility to healing after their addiction and long-term sobriety is solely up to them. The participation of clients in their own recoveries increases their chances of a favorable, effective outcome.
These are only a few rights and responsibilities that clients and treatment centers have to each other.
It is estimated that there are more than 14,000 specialized drug treatment centers in the U.S. While that means there’s plenty to choose from, it also means making the decision to choose just one that more difficult. Everyone is encouraged to ask the necessary questions that can give you a clear idea of whether a center is the right one for your or your loved one.
While you likely will have questions of your own, SAMHSA has highlighted several in five important areas that can help prospective clients assess the quality of treatment offered at a facility. It writes, “Good quality programs will have a good inspection record and both the program and the staff should have received training in the treatment of substance use and mental disorders and be licensed or registered in the state.”
Accreditation is an important category to start with. It is advised that you check the facility’s accreditation you or your loved one is considering with the Joint Commission and the Commission on Accreditation of Rehabilitation Facilities.
The Joint Commission (JCAHO) is a nonprofit organization that provides independent accreditation and certification of health organizations. Organizations that seek accreditation must first be approved by JCAHO. Those facilities must exhibit high quality and performance levels before they are accredited with JCAHO’s seal of approval. You can search for find accredited organizations on theJoint Commissions’ website.
If you want to guidance on what to inquire about, SAMHSA advises these questions in the areas of accreditation, medication, evidence-based practices, families, and supports.
Has the program been licensed or certified by the state? Is the program currently in good standing in the state? Are the staff qualified? Does the program conduct satisfaction surveys? Can they show you how people using their services have rated them?
Does the program offer FDA-approved medications for recovery from alcohol and opioid use disorders? At this point in time, there are no FDA approved medications to help to prevent relapse from other problem substances.
Does the program offer treatments that have been proven to be effective in treating substance use disorders including medication management therapies, such as motivational therapy, cognitive behavioral therapy, drug and alcohol counseling, education about the risks of drug and alcohol use, and peer support?
Does the program either provide or help to obtain medical care for physical health issues?
Does the program include family members in the treatment process? Family members have an important role in understanding the impact of addiction on families and providing support.
Does the program provide ongoing treatment and supports beyond just treating the substance issues? For many people, addiction is a chronic condition and requires ongoing medication and support. Quality programs provide treatment for the long term which may include ongoing counseling or recovery coaching and support. They also help in meeting other basic needs like sober housing, employment support, and continued family involvement.
When a person develops an addiction to any substance, a great deal happens to them. Their health often suffers from the perpetual habit of substance use. Over time, this can cause adverse effects on a person’s mental and physical state.
In most cases, substance addiction treatment will be ongoing as addiction is a chronic disease. A one-time treatment will not be enough for people to stop using drugs and alcohol. Learn more about addiction therapy
Once addiction treatment is completed, it is reasonable and wise to expect that this is only the beginning of the addiction recovery process, not the end. Managing an addiction can be a lifelong process that requires remaining committed to changing daily habits, attending support group meetings, joining groups that share the recovery goals you do, and staying in tune with yourself and surroundings so you can recognize your personal triggers.
The road to recovery after a bout with addiction means there will be times when relapse will occur. It is almost expected. Relapse is when a person returns to using drugs and alcohol after a period of abstinence. The possibility of this happening to someone who has completed addiction treatment is real. Even people who have made their best attempts to fight off cravings for addictive substances can relapse.
Because science tells us that addiction is a chronic brain-altering disease, it is common that people in substance use recovery are prone to return to using. The National Institute on Drug Abuse (NIDA) reports that relapse happens to 40 to 60 percent of people in recovery.
NIDA advises that addiction must be treated like any other chronic illness, such as asthma, diabetes, and hypertension. It is possible that a person will visit addiction rehab more than once or twice as they continue on the path to recovery.
Relapse can be viewed unfavorably, and some people will think it indicates a lack of willpower or commitment on the part of the person in rehab. This is not true. It is believed in the addiction community as well as in the science and medical fields that relapse does not indicate that treatment has failed. Instead, it means treatment needs to be reinstated or adjusted, NIDA explains, or that another form of treatment is needed altogether.
This is one reason why it’s critical that treatment centers provide engaging interventions that encourage clients to finish their treatments and discourage them from leaving early. It helps to have strategies to combat relapse and continue on. Treatment centers can help clients create those strategies. If you or a loved is on the verge of relapse or are in relapse, consider seeking professional addiction treatment.
It is believed that a relapse follows a conscious decision to return to uncontrolled substance use and abuse despite previous attempts to adhere to a recovery plan. This decision can lead to more life-threatening situations. One of those situations is overdose.
Resuming drug use after a break in which drugs were not consumed can spark urges to take more of it and in higher doses, which can lead to overdose and death.
Many people who abuse addictive substances will not make it into rehab and are at risk of overdose and death. Deadly drug overdoses continue to claim thousands of lives, so treatment is an option to avoid that outcome.
Addiction treatment can come with a hefty price tag. An inability to pay for itdeters many people in need from pursuing options, further putting themselves at risk of staying in the addiction cycle and risking their lives. According to data from the 2015 National Survey on Drug Use and Health (NSDUH), an estimated 19.3 million people age 12 and older who were classified as needing substance use treatment did not receive it at a specialty facility in 2015. That means nearly 20 million people who needed services for a substance addiction who did not receive them. Cost likely was stopping them from entering treatment.
Cost is even an issue for people who have health insurance. Not all insurers cover the costs of health and addiction services the same. It’s also possible for centers to not accept some insurance. It is advised that people who have insurance call their insurance provider to find out exactly what’s covered, what’s not covered, and what options prospective clients have in receiving the services they need. If you or your loved one don’t have insurance coverage, SAMHSA reports that each state has funding for people who don’t have coverage.
How addiction is viewed by the general public greatly influences how the disease of addiction is seen and is treated and if those who are struggling with addictive disorders get the help they need. People with drug addiction are more likely to be viewed unfavorably than those who have a mental health disorder, according to research conducted by the Johns Hopkins Bloomberg School of Public Health research and published in the Psychiatric Services journal in 2014. According to researchers, addicts’ condition is seen and considered as a “moral failing.”
“While drug addiction and mental illness are both chronic, treatable health conditions, the American public is more likely to think of addiction as a moral failing than a medical condition,” study leader Colleen L. Barry, Ph.D., MPP, an associate professor in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health, said in a press release about the study.
Barry went on to say, “In recent years, it has become more socially acceptable to talk publicly about one’s struggles with mental illness. But with addiction, the feeling is that the addict is a bad or weak person, especially because much drug use is illegal,” Barry said.
There are substance users who think they don’t need addiction treatment. Some people in this population are using drugs, alcohol, and other addictive and harmful substances to cope with hardships or emotionally difficult areas in their lives. To give those vices up to get help is far harder than to just continue on with abusing substances.
Just as there are people who are in denial about their substance use, there are people who are aware their drinking and drugging have reached a level where it’s out of control, but they’re not ready to give up the wild ride. Substance users in this group know they have a problem and need help, but are not ready to stop using their drug or drugs of choice. Shame falsely makes users feel they are not ready to let go of a life of substance use. This is a risky decision, and it’s definitely one that keeps them locked into the vicious cycle of addiction.
Going to drug or alcohol rehab scares away many people who need the help that is waiting behind those facility’s doors. Getting addiction treatment will make them face their fears and the truth and hold them accountable for leaving behind drugs and alcohol for something better. While it’s understandable that the unknown can be scary or uncertain, it should not be a reason to get life-saving treatment.
The new start that people in treatment work hard for is just beginning when they walk out of treatment. They will not go at it alone for there are many supports out there to help them make it through. There are recovery homes, known as sober homes, that serve as a haven for people in recovery as they learn to reintegrate into society.
Recovering users can also join an alumni program, like the one offered by Pathway to Hope, or a 12-step program.