Understanding The Addiction Recovery Process
What is Rehab?
Addiction is a complex, chronic, and often-relapsing condition, but it is one that can be effectively managed with the help of a comprehensive addiction treatment plan.1 Rehab helps many struggling with addiction to achieve long-term sobriety. These types of programs are designed to help people struggling with a variety of substance addictions—including alcohol, heroin, methamphetamine, cocaine and prescription drugs—to begin recovery.
Recovery from addiction is a process; speaking with experienced medical and mental health professionals can help you determine the best course of action. If you’re unsure of your need for help, ask yourself if an addiction is consistently getting in the way of your daily life. If the answer is yes, you may benefit from professional addiction treatment.
Signs & Symptoms of Addiction
According to The American Society of Addiction Medicine (ASAM), “Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships and a dysfunctional emotional response.”
Below are some common signs and symptoms to be aware of if you’re concerned about your own alcohol or drug use, or that of a friend or loved one. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) categorizes substance use disorder into three categories: mild (two to three criteria), moderate (four to five criteria) and severe (six or more criteria).2
If two or more of these signs or symptoms are present in a consecutive 12-month period, you may meet criteria for diagnosis of a substance use disorder and might benefit from substance abuse treatment.2
- Inability to quit using drugs or alcohol despite attempts to do so.
- Inability to meet work, social or family obligations because of use.
- Spending a great deal of time obtaining, using or recovering from the effects of the substance.
- Withdrawing from family activities and hobbies in order to use substance.
- Almost all of the individual’s daily activities revolve around the substance.
- Awareness of its harmful mental or physical effects but continuing to use the substance anyway.
- Tolerance to the effects of the substance have developed.
- Symptoms of withdrawal occur when attempting to quit or cut back on the substance.
How Does Detox Work?
With certain types of substance use, before entering into a rehab program, it could be necessary to go through a detox process to help safely manage the withdrawal period. Because detox from alcohol, sedatives, and opioids can be wildly unpleasant, dangerous or even life-threatening when not managed properly, medical supervision can help ensure a safe and comfortable withdrawal.3
Although less common, outpatient detox programs may be an option for people with less severe addiction issues. In such a situation, patients will have regular check-ins with their treatment team and may receive prescription medication dispensed directly from the medical office—such as might occur with buprenorphine. In cases of more severe physiological dependence or addiction, an inpatient or residential detox protocol may be recommended to ensure medical professionals are present in the event of an emergency.
Following detox, you’ll begin (or will be encouraged to transition into) an inpatient or outpatient rehabilitation program that typically includes a mix of individual, group and family therapy sessions. It also may involve regular participation in support groups and ongoing medication management.
What Happens During Withdrawal?
During the detox process, users will experience withdrawal4 which refers to the body’s reaction to abstaining from the abused substance. Withdrawal may be both psychological and physical in character, though the specific drug-associated syndromes vary across the classes of abused substances.5 Acute withdrawal can range from uncomfortable aches to life-threatening seizures. Different withdrawal symptoms may persist for days to weeks or can be protracted, lasting months to years.5
The character and duration of symptoms may also be influenced by factors such as age, health, history of severe withdrawal, how long you used the substance and how heavily it was used. Certain substances require medical attention due to the severity of their withdrawal symptoms such as benzodiazepines (e.g., Xanax, Valium) or alcohol.
Types of Addiction Treatment
There are a number of treatments available to those seeking recovery. Because each person is somewhat unique, it is unlikely that any given program will fit everyone’s needs. Some may benefit more from inpatient treatment while others may meet their recovery needs by going through the process as an outpatient. Some of the options that may be available to you include:
- Inpatient Residential Programs—There are both short and long-term programs available for inpatient treatment. These programs involve living within a facility with the support of staff and peers alike, while attending ample group therapy and individual counseling sessions. Shorter programs may last 28 or 30 days while longer ones usually last 90 or more days, as needed.
- Outpatient Programs—Typical outpatient programs involve living at home or outside of a facility while receiving addiction treatment.6 Standard programs will work toward recovery for one hour a day while intensive outpatient programs (IOP) focus on 10-12 hours of recovery programming per week. Those in partial hospitalization programs (PHP) may experience recovery programming for around six hours a day, five days a week.
- Behavioral Therapies—Various behavioral therapy modalities may be used within inpatient and outpatient programs. There are a several evidence-based behavioral therapies that you may receive including cognitive-behavioral therapy, contingency management, 12-step facilitation, matrix model and motivational interviewing. During these sessions, patients will meet as part of a group or one-on-one with the therapist or counselor daily, weekly or at other regularly-scheduled intervals. Various forms of behavioral therapy have been successfully applied to help people to change maladaptive behavior patterns and thoughts surrounding their substance use.
Along with the above-mentioned programs and therapies, certain FDA-approved medications may be used to manage opioid and alcohol dependence based on your specific treatment plan. A consultation with a physician, psychologist or other addiction treatment professional would help you best determine an appropriate level of care or the specific type of rehab that would best suit your recovery needs.
The Essentials of Aftercare
Aftercare describes any ongoing recovery and abstinence maintenance measures that follow the initial treatment period. Many people struggling with addiction are at risk for relapse once they are released from their treatment center or complete their programs.
To have the most success with your recovery, adhering to aftercare recommendations is essential. ASAM reports that individuals who complete rehabilitation programs without engaging in aftercare programs relapse at rates approaching 100 percent. Treatment providers will help to create these aftercare plans prior to completing inpatient and outpatient care. Some of the available aftercare options include:
- 12-step meetings
- Sober living arrangements (e.g., recovery communities, halfway houses)
- Regularly-scheduled individual and group therapy sessions
- Step-down treatment (e.g., following your initial, inpatient rehabilitation stay with a formal outpatient program)
Sources
[1]. Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 16-4984, NSDUH Series H-51).
[2]. Diagnostic and statistical manual of mental disorders: DSM-5. (5th ed.). (2013). Washington, D.C.: American Psychiatric Association. 483-484.
[3]. Center for Substance Abuse Treatment. (2015). Detoxification and substance abuse treatment. Treatment Improvement Protocol (TIP) Series, No. 45. HHS Publication No. (SMA) 15-4131. Rockville, MD: Center for Substance Abuse Treatment.
[4]. U.S. National Library of Medicine. (2017). Alcohol withdrawal.
[5]. U.S. National Library of Medicine. (2016). Opiate and opioid withdrawal.
[5]. Center for Substance Abuse Treatment. (2010). Protracted withdrawal. Substance Abuse Treatment Advisory, 9(1).
[6]. Center for Substance Abuse Treatment. (2015). Services in Intensive Outpatient Treatment Programs. Substance Abuse: Clinical Issues in Intensive Outpatient Treatment, Series, No. 47. Rockville, MD: Substance Abuse and Mental Health Services Administration.