Addiction is a chronic disease that changes how the brain releases neurotransmitters, which can then change the shape of certain parts of the brain. Compulsive behaviors around consuming drugs or alcohol, or performing certain acts like gambling or dating, are associated with cravings as brain chemistry changes when addiction manifests.
Like other chronic illnesses, addiction can be treated and managed on a long-term basis with evidence-based approaches. This includes lifestyle changes guided by behavioral therapy, and it sometimes includes prescription medication.
If you struggle with addiction, you may wonder what it looks like to get into an addiction treatment program. Whether you choose an outpatient program or an inpatient or residential program, there are steps you can take to prepare, which will allow you to focus on your mental, emotional, physical, and behavioral health, bolstering your ability to avoid relapse and stay healthy. This starts with understanding what addiction treatment is and what the core components of evidence-based treatment are.
The very first week or two of treatment, this process involves medical supervision to overcome the body’s dependence on chemicals in drugs or alcohol to feel normal.
This process is for some types of detox, such as from opioids or alcohol, that involve intense physical dependence. It involves using a prescription medication like buprenorphine or Valium to slowly taper the individual off the physical need for the drug. Not all approaches to detox require MAT, but it is an important component of detox for thousands of people.
This may occur in a medical setting or a counselor’s office, and it is essentially a way to convince someone who is ambivalent about treatment, and that they need help and must seek treatment to overcome their addiction. After detox, it is a way to persuade the person to continue into rehabilitation.
This second major pillar of treatment involves behavioral therapy, primarily in group therapy; however, in intensive outpatient treatment, management of co-occurring disorders (dual diagnosis), and inpatient treatment, individual counseling may also be used. Family therapy is increasingly an important component of rehabilitation.
This is a component of some approaches to rehabilitation, which reduces the risk of relapse.
This is an approach to group support that can be used before, during, and after detox and rehabilitation. These groups can be a way for someone considering treatment to understand how serious addiction is and how they can get help; they can bolster outpatient treatment programs; and they provide ongoing social support after completing rehabilitation.
Once you decide that you are going into treatment because you can benefit from the above components of detox and rehabilitation, there are several steps and factors you should consider to prepare yourself.
A therapist, addiction specialist, or physician can help you get started on the right path. They can assess your situation to understand how serious your addiction or substance abuse patterns are, determine if you have any co-occurring mental health problems or chronic physical illnesses, and refer you to an appropriate level of care. You also can discuss any concerns you have about the length of treatment, insurance coverage of treatment or overall cost, and whether you are safe at home during or after rehabilitation.
You must be honest about your drug or alcohol use during this appointment, including how long you have struggled with substance abuse, which substances, and how much you took. A medical professional will not report you to the police for using illicit drugs, prescription drug abuse, or alcohol problems. They want you to get help and will focus on that process.
You should also be clear about any prescription drugs, herbal supplements, or vitamins you take, so the physician and the specialists in the detox program can know what you need to take to stay healthy and how these substances may affect MAT if you need to taper off an abused substance.
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Your physician or therapist can refer you to detox and rehabilitation, but you also have a great amount of control over which type of program you enter. Detox referrals will be based primarily on your physical needs, so it is important to consider a physical assessment when you decide where to go. After completing detox, rehabilitation is a customizable process.
The American Society of Addiction Medicine (ASAM) details a Continuum of Care to help those struggling with addiction and their loved ones understand the basic rehabilitation options.
This involves less than 10 hours per week of group therapy, allowing the individual to live at home and continue to go to work and support their family.
This involves more than 10 hours of treatment per week, usually around 20 but less than 30 hours. Group therapy is still the focus, but patients will also have access to individual counseling and MAT as needed. This program is short-term—often about a month or less—but requires several full days of treatment per week so patients may have to take a leave of absence from work.
This is much like intensive outpatient treatment, so the person can live at home and goes to therapy for about 20 hours per week; however, this program may offer a day or a few days of inpatient hospital treatment for severe psychiatric or physical conditions as needed.
This involves 24-hour care for one to three months, primarily offering group therapy and individual therapy, nutritional support, job or life skills counseling, and complementary treatments like yoga, meditation, art therapy, equine therapy, and more.
Like Level 3, this level involves living at a facility for several weeks or months; however, this level also involves ongoing nursing support, prescription medications for a variety of conditions, and consistent monitoring from a physician to manage health problems.
Your doctor or therapist can help you determine which of these levels is most appropriate for you; however, you may have your personal needs that determine whether you attend inpatient or outpatient treatment.
For example, if you cannot stay away from friends who abuse substances, you may choose inpatient treatment even if you are otherwise safe to live at home.
Conversely, if you need to continue to work so you can afford treatment, or you need to stay involved in your family life on a daily basis, you may choose outpatient treatment over the inpatient option.
Once you have received a diagnosis, a treatment referral, and decided which facility you will enter, you must notify your job, friends, and family that you are getting addiction treatment, especially if you need time away from everyone. There are several reasons for notifying everyone before you leave.
If you are leaving home for addiction treatment—whether it is for a day or two, or three full months—it is important to know what to pack. Generally, packing for a detox and rehabilitation program involves packing plenty of comfortable clothes and needed items, and leaving inappropriate or high-value items at home. This means you can pack personal essentials, but do not pack prohibited items or objects that may be stolen.
Patients should always bring in all medications as well as their current physician’s name and phone number. This is needed to confirm all medications and destroy contraband.
You may find, after you have chosen a detox and rehabilitation program, that you are on a waiting list. Many people require the medical supervision provided by some detox and rehabilitation programs, which means facilities may not have free beds. You may choose to call and ask, or have a trusted loved one call and ask, a few more treatment programs to see if the facility is taking new clients. If not, you can make the waiting process easier for yourself in several ways.
Evidence-based treatment will help you overcome addiction, and it is worth the cost. Take the steps you need to care for yourself, starting from your first physician’s appointment for a diagnosis, and finishing with an aftercare plan and a focus on long-term recovery.
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