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Substance Abuse: Treatment Approaches for Drug Addiction

Substance Abuse: Treatment Approaches for Drug Addiction Drug addiction is a multifaceted issue that cannot be fixed by simply not using drugs. The chemicals in substances, by nature, affect the brain's ability to process and interpret information, so clear signs of damage (e.g. an eroding nose septum or irregular heartbeat) might not even matter to a drug abuser while they're using. Furthermore, a person's drug use is often supported by suppliers, friends, or even family members, so ending drug abuse involves more than just not using. In seeking treatment, each person must determine what kind of help they need, and where is best for them to get it.

The process of rehabilitation is neither short nor easy. However, the rewards and outcomes of successful and lasting recovery are irreplaceable: you get your life back. Those who go through rehab and come out the other side often emerge as more self-actualized adults, able to handle challenges in their lives without drug and alcohol addiction. They are also happier and healthier, able to pursue their dreams and form solid relationships.

If you or someone you love struggles with drug or alcohol addiction, know that rehabilitation and recovery is possible. You can get the help you need to live a nourishing and fulfilling life.

Types of Facilities:

All facilities can be divided into inpatient and outpatient services. With inpatient treatment, people choose live-in treatment; outpatient treatment means you're free to go home at the end of sessions. This is important, as inpatient services are frequently suitable for chronic and severe cases, and more expensive due to their round-the-clock care and intensiveness. However, this doesn't mean outpatient is any less effective. Many times, people cannot afford to take weeks or months off work, so having outpatient treatment that can work around their schedule is ideal.

Inpatient rehab programs:

Inpatient drug and alcohol rehab facilities offer 24/7, residential care. Because all needs are taken care of (food, housing, medication, therapy, treatment), you are free to focus solely on recovery. Inpatient rehab is particularly recommended for those who have either struggled with drug or alcohol addiction for an extended period of time, or those with a dual diagnosis (people who have a mental health condition or other condition in addition to addiction).

Inpatient drug and alcohol rehab programs take place either within an actual hospital or at a standalone residential facility. In addition to standard inpatient rehab programs, luxury drug and alcohol rehab centers offer upscale facilities in retreat-like settings, and executive rehab centers cater to professionals who wish to continue working while they go through substance abuse treatment.

Facilities can be further categorized into those dealing with specific issues, like mental health, alcoholism, or a class of drugs like opioids. In many cases, people with a drug addiction also have another mental illness, which developed either before or during using. Mental health treatment centers focus on finding better ways of coping with issues (e.g. depression, anxiety, PTSD, etc.) beyond substance abuse. They include diagnoses and various types of therapies explained below. Opioid-specific facilities accept only those who abuse opioids and offer treatments tailored to that population. These may include a strong focus on pain management and medicated treatments for detoxification. Creating a community where all patients share similar experiences is a solid basis for recovery, as it offers access to like-minded people for support.

General substance abuse facilities do exist and are primarily aimed at people with acute or less severe symptoms. These can range from mild drug use to chronic users whose symptoms are less obvious than more severe cases. Either way, all treatment facilities have the same basic aims:

  • Help patients stop using the drug(s)
  • Give patients the tools needed to stay drug-free
  • Help patients with life skills in order to feel fulfilled overall

Each patient should have clear discussions with their medical provider about their treatment plan, which includes types of therapies and what the process will entail. The plan is subject to change according to the circumstances and should be molded for each person.

Outpatient rehab programs:

Outpatient drug and alcohol programs offer many of the same services as inpatient rehab programs, but patients live off-site, at home. If you aren't able to leave home for substance abuse treatment for some reason (for example, you have children), attending outpatient rehab may be the better option for you.

Outpatient drug and alcohol rehab is also an option for those whose addictions are less established. If you have a dual diagnosis or a very severe addiction, inpatient rehab will likely be the better choice. If you already know you have a dual diagnosis (i.e. alcoholism and bipolar disorder), you should also consider looking into a dual diagnosis treatment center.

Treatment Types:

A variety of treatment options exist to cater for specific needs. Some focus more on mental wellbeing and establishing mindfulness, while others focus on being physically fit or how to reintegrate into society.

A good example of a specific treatment concept is the 12 step program, a plan created by the founder of Alcoholics Anonymous to stop drinking. It emphasizes seeing addition as not being a choice (the first step is, "We admitted we were powerless over alcohol.") By admitting addiction is a problem and seeking to get help to resolve it, the 12-step program is a very good way of addressing one's own needs within the structure of a wider context and community. Furthermore, the last few steps require a person to "make amends" with those they've wronged, which forces people to acknowledge the consequences of their actions. This originally Christian-based treatment system worked so well that non-Christians adapted the 12 step program to contain less religious language, focusing on self-reliance and resilience instead of putting one's destiny into God's hands. Often when enrolled into a treatment facility, healthcare staff will work with a patient on the first few steps, while the rest is completed by the patient him/herself to foster independence.

Another specific treatment is buprenorphine detox. This is a form of medication-assisted therapy where medication is used to help with addiction and/or dependency. Buprenorphine itself is a chemical that responds to the same receptors in the brain as opioids (like codeine, fentanyl, and heroin), but displaces them instead of copying their effects. The brain receptors will prefer the medication and it will help minimize the symptoms of withdrawal. It is important that a person has undergone detox before taking it, so doctors can prescribe the suitable dosage. If not, the person could experience horrendous withdrawal symptoms that could make the "getting clean" process very difficult.

As a daily medication, doctors will require visits twice a week, which will taper over time. This is to ensure the dosage is correct and that adjustments can be made. Most people will start to feel normal (no side effects) within the first few weeks, as the buprenorphine completely blocks the chance for opioids to affect the brain. This doesn't mean one should test the medication by sampling opioids -- just because you don't feel the "high" doesn't mean it's not harming your body.

People tend to be prescribed this kind of medication for several months, as studies show that the longer one is medicated, the greater the chance of staying abstinent. To be completely off buprenorphine, the doctor will start reducing the dosage for the body to adjust and taper it off; people rarely notice any difference.

Medically-assisted detox also exists to treat those who are dependent on drugs. This is when the body actually requires the drug to function in some capacity, so when it's taken away, the body responds with painful withdrawal symptoms as a way to signal for help. Medication for opioid use also includes Subutex and Vivitrol, both of which stop cravings and pain. Because this is an intensive treatment that excludes all access to the abused substance, it is always an inpatient service where patients are carefully monitored.

Like the mental health treatment facilities mentioned above, psychotropic medication may also be used to treat patients with depression, anxiety, schizophrenia, bipolar disorder, obsessive-compulsive disorder (OCD), and/or attention deficit disorder (ADD). This family of medications can be used by medical providers to treat the symptoms the patients were trying to deal with substance abuse. However, these medications are able to alter a person's emotions and behavior, so they must be prescribed by and monitored closely by a professional. This form of treatment also tends to be lifelong, as they treat issues linked to a person's genetic predisposition.

More holistic treatments focus on a person's feelings, body sensations, and overall health, and include yoga, meditation, bio-feedback brainwave meditation, and creative arts therapy. These are often processes that more qualitative, where the end goal is to be aware of one's thoughts and surroundings. Bio-feedback is a process where brain waves are projected onto a screen and patients can directly observe their electrical impulses. By seeing what happens when a person is angry or anxious, it creates tangible goals they can work on.

Yoga, meditation, and qi gong are all mindfulness exercises that help unify the "mind, body, and soul." Through breathing exercises, understanding subtle body movement, and finding inner equilibrium, patients can begin to relieve their own stress and process why they experience emotional distress. Many times substance abuse can lead to disassociation between mind and body, where one's body might feel foreign or one might have an out-of-body experience. Exercises that make a person aware of their own thought process and body can help connect the two again.

Another form of holistic treatment is art therapy, either in the form of music, drawing, or writing. Such therapies give people the chance to express their thoughts and emotions in a way other than talking. In modern life, speaking is the most common way of communicating and expressing, but other forms of expression are equally as valid and shouldn't be brushed off or labeled 'immature' or 'juvenile.' For example, drawing with different textures and colors or expressing with non-verbal sounds can help people access things words would never be able to fully express. Art therapy and non-traditional therapeutic methods can thus open up other channels of communication that can help find the source of the problem(s) as well as the resolution.

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Drug treatments in Virginia

Mount Regis Center

Substance, Drug And Alcohol Abuse 800-477-3447 | Private
405 Kimball Avenue Salem, VA 24153

Boxwood Residential Program

Mental Health, Substance, Drug And Alcohol Abuse 540-547-2760 | Public
15511 Guinn Lane Culpeper, VA 22701

Phoenix House - Girls Recovery Lodge

Mental Health, Substance, Drug And Alcohol Abuse 703-841-0703 | Private
521 North Quincy street Arlington, VA 22203

Phoenix House - Boys Recovery Lodge

Mental Health, Substance, Drug And Alcohol Abuse 703-841-0703 | Private
521 North Quincy street Arlington, VA 22203

Navy Substance Abuse Rehabilitation Program (SARP)

Substance, Drug And Alcohol Abuse 757-953-7848 | Public
620 John Paul Jones Circle Building 104 Portsmouth, VA 23708