Drug and Alcohol Addiction Treatment

The first step toward recovery is getting informed about what to expect during treatment. Establishing realistic expectations about the recovery process eliminates uncertainty and nervousness, replacing fear with reassurance and determination. Once you know the steps to sobriety, the tools designed to combat challenges, and the support system available to you, you are more likely to begin treatment.

Understanding the Addiction Recovery Process

Treatment for addiction and substance use is not designed to be a cure, but a process to enable individuals to manage their illness better in order to be able to function in everyday life. Like other chronic illnesses, it’s not uncommon to experience relapse throughout the course of one’s life or change the type of treatment down the road. It is with this feature in mind that addiction recovery places an emphasis on preventing relapse in the future. During the addiction recovery process, an individual can learn techniques that reduce the chances of relapse by identifying triggers and managing cravings.

Statistics

Drug abuse is a common problem. Up to 12 million people report illicit drug use, with 6.5 using prescription drugs for non-medical uses according to the National Survey on Drug Use and Health. 17 million people reported alcohol use disorder and 7.1 million people reported illicit drug use disorder, with 12% of people exhibiting both. There is also a high degree of overlap between substance use disorders and other mental illnesses, with 7.9 million people (39.1%) experiencing both. Relapse is common even after addiction treatment, with 40-60% experiencing episodes of relapse. According to the Institute on Drug Abuse, this is not unlike relapse rates for other chronic illnesses like hypertension.

Types of Addiction Treatment Programs

An individual’s needs and desires are always considered when designing a specific treatment plan. Taking into consideration other mental health issues, present circumstances, and individual goals is key to designing the best possible treatment plan. Treatment typically follows a general structure, designed to be completed in progression in order to best equip individuals with the tools they need to maintain their sobriety after completing rehabilitation. While the plan can be adjusted to accommodate the individual, we believe the most effective treatment follows this structure: medical detox, inpatient treatment, outpatient treatment, and partial hospitalization.
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Medical Detox

It can be challenging to address triggers and goals for sobriety when undergoing symptoms of withdrawal. That is why the first step in addiction treatment is often medical detox. Detox is the process by which the body physically eliminates a drug. In cases of severe addiction, this can be an unpleasant experience and bring on severe withdrawal symptoms. Medical detox makes it easier to get through this period through the alleviation of symptoms and close monitoring to prevent relapse.

Inpatient Treatment

Inpatient treatment provides a safe and therapeutic environment for individuals to reside in while they undergo treatment. After detox, this period is key in developing a framework for a successfully recovered life. Patients benefit from having 24/7 access to medical support as well as structured therapy sessions that include individual and group sessions. During this time, when substance cravings are most intense, individuals can focus on learning productive skills to manage their addiction.

In addition to these programs, they may take part in healthy support programs like exercise, yoga, or meditation in order to recuperate away from the stress of daily life and the usual triggers. By establishing healthier habits and being surrounded by people with similar sobriety goals, individuals are in a better frame of mind to achieve long-term change.

Partial Hospitalization

The partial hospitalization program (PHP) is designed to follow inpatient rehabilitation, though it can serve as an alternative to inpatient treatment in some cases. It is a part-time program that allows individuals to attend treatment several hours a day while still living at home. The nature of the time spent at the addiction treatment center is similar to that which is offered as part of inpatient treatment, including group and individual therapy and constructive social activities. However, while it still provides structure and support, it also allows for autonomous flexibility which enables individuals to learn to maintain their sobriety and use coping skills that will help in everyday life.

Outpatient Treatment

Outpatient treatment is the most flexible treatment option, as it lets individuals return almost completely to their daily lives while providing the support of therapeutic intervention only a few days a week. At this stage, individuals have strengthened their life skills and are themselves accountable to enact relapse prevention methods learned during the course of treatment. Access to outpatient treatment can reduce the likelihood of relapse while taking on normal responsibilities.

If necessary, intensive outpatient treatment can serve as a step between partial hospitalization and outpatient treatment. This typically involves at least nine hours of service per week, and may be appropriate when an individual is transitioning out of inpatient rehabilitation.

Addiction Treatment Process

In order to establish the most effective treatment plan, addiction treatment generally follows a series of successive steps that work together and build upon one another to achieve lasting recovery. Through these steps, clinicians are able to uncover the severity of the issue, identify individual challenges to recovery, and enact a plan to overcome those challenges while emphasizing coping mechanisms and motivation to maintain long-term gains.

Diagnosis

Before any kind of treatment can begin, an individual must first be diagnosed to determine the existing issues and their severity that rehabilitation will focus on. This can involve drug testing, and psychological or medical assessment. It is crucial to determine underlying factors that may impede recovery including mental illness or physical conditions that co-occur with substance abuse and addiction.

Diagnosis also involves assessing the degree to which addiction and substance abuse affect a person’s ability to engage in day-to-day activities. This could include professional responsibilities, relationships, and other behaviors. Using this information, the treatment team can begin to map out the path to recovery with a focus on specific problematic areas.

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Medical Detox

Medical detox is an essential step in recovery that safely eliminates addictive substances from the body. Detox may be necessary to complete before diagnosis if an individual experiences a life-threatening overdose. This physical process occurs naturally when substance use is discontinued and there is no way to skip or shorten this step. However, it can be facilitated by medical professionals who will help manage withdrawal symptoms and ease cravings. The detox process generally takes about a week, but depending on the severity of the addiction, it can be completed in a matter of days to a couple of weeks.

Therapy

Therapy may begin concurrently with detox. This step in the addiction treatment process helps dive deeper into the issues of substance abuse and addiction to uncover the mechanisms that enable continued use. As therapy progresses, it aims to develop healthier coping skills and focus on relapse prevention.

There is no one-size-fits-all therapy, so individuals can take part in different types of therapy according to their preferences and rehabilitation needs.

  • Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy seeks to identify maladaptive thoughts and behaviors that lead to a cycle of substance abuse. Individuals are taught to challenge unhealthy thoughts and replace unhelpful behaviors to break the cycle. 

  • Motivational Interviewing (MI) 

Motivational interviewing can help the treatment of those who struggle to take charge of their own recovery. It can instill acceptance and confidence in a person’s ability to achieve sobriety.

  • Motivational Enhancement Therapy (MET)

Like motivational interviewing, motivational enhancement therapy increases the desire for recovery in part by reducing ambivalence about the process. 

  • Dialectical Behavioral Therapy (DBT)

This is a modified version of CBT, focusing on regulating emotions and helping people learn to cope with stress. Dialectical behavioral therapy aims to reverse problematic behavior patterns. 

  • Traumatic Incident Reduction Therapy (TIR)

When substance use is related to trauma, traumatic incident reduction therapy can help people overcome the impact of such experiences.

  • Reality Therapy

Reality therapy is an approach that views behavior as choices with the aim of helping people take responsibility and learn to make better choices.  

  • Solution-Focused Therapy

Though it acknowledges past causes to problems, solution-focused therapy focuses on resources and future goals to solve these problems.

  • Eye Movement Desensitization and Reprocessing (EMDR)

EMDR is designed to create desensitization to trauma and stress through a series of eye movements that are meant to distract from the emotional pain. 

  • Biofeedback

Biofeedback allows individuals to become more aware of automatic processes in the body like blood pressure and heart rate with the aim of achieving some control over those processes. 

  • Neurofeedback

Neurofeedback uses brain activity monitors like electroencephalography (EEG) to teach self-regulation of brain function. 

  • Optional 12-Step Recovery Groups

Group treatment allows individuals to help each other achieve recovery through a 12-step process.

Peer Group Work

A social support group can be an important component of addiction treatment. That’s why many treatment programs use the 12-step model to link patients with others who suffer from similar illness and who are working toward recovery. By engaging in group therapy, individuals may feel more confident and motivated to continue with the program.

Peer group work can foster increased accountability to remain sober, not only for themselves but as a commitment to the group dynamic. This acts as a powerful motivation to stay sober. Participation in group therapy can also help cultivate long-term relationships with supportive individuals who can prevent relapse in the future by helping each other navigate triggers or stressful periods.

Aftercare

Some people may find it helpful to participate in aftercare programs, like therapy or 12-step meetings, after addiction treatment is over. This provides ongoing access to resources during increasing exposure to potential triggers as the individuals returns to their daily life. Aftercare also involves maintaining connections to supportive peers and professionals at the center who can provide a safety net months or years later if needed.

Long-term Sobriety

Recovery is not a finite process but a lifestyle. Individuals are more likely to achieve long-term sobriety if they had adequate treatment, allowing them to internalize processes and skills learned during rehab. As long as these skills are practiced and wellness is emphasized, the process of recovery continues successfully.

Relapse is a normal part of recovery and may indicate that treatment should be adjusted or skills honed in order to maintain long-term sobriety. Regular participation in therapy programs or 12-step groups can provide ongoing motivation and resources to stay on the track of long-term recovery.

Treatment FAQs

References:
  1. https://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf
  2. https://www.asam.org/asam-criteria
  3. https://www.asamcontinuum.org/knowledgebase/what-are-the-asam-levels-of-care/#what-is-asam-level-2-5
  4. https://www.mayoclinic.org/diseases-conditions/drug-addiction/diagnosis-treatment/drc-20365113
  5. https://www.uwhealth.org/health/topic/special/inpatient-and-outpatient-treatment-for-substance-use-problems/ad1101.html
  6. https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-long-does-drug-addiction-treatment
  7. https://www.drugabuse.gov/publications/principles-drug-addiction-treatment/evidence-based-approaches-to-drug-addiction-treatment/behavioral-therapies
  8. https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment
  9. https://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction
  10. https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery
  11. https://psychcentral.com/lib/relapse-prevention