Addiction Help and Rehab Information
What to Expect From Drug Rehabilitation and Recovery Programs
You can beat your addiction. Help is available. In fact, you can find it with just a single phone call.
Today, many types of drug and alcohol rehab centers offer care and support. And many groups and facilities also offer treatment for addicts with behavioral dependencies and compulsive disorders. As a result, the better life you hope for is possible to achieve. Your future really can include a restoration of important relationships, a revived sense of self-worth, and many other positive changes.
So learn how to make a well-informed choice for yourself or a loved one. Support groups and treatment centers for addiction vary in their approaches. But they all have the goal of helping people like you get their lives back.
Addiction Treatment Settings
Substance abuse treatment or behavioral addiction rehab can take place in a variety of settings. These include inpatient or residential programs, outpatient settings, intensive outpatient programs, self-help groups, and programs in transitional settings such as sober living communities or halfway houses.
Choosing an appropriate rehab facility or addictions treatment setting often depends on the factors that are influencing your particular situation. Here are a few examples:
- Physical dependence and medical risks—If you are in need of medical supervision for withdrawal and detox, you will need to be in a setting with 24-hour monitoring and medical staff. Using certain types of addictive substances in significant amounts and over a prolonged period of time can cause health complications if you are going through withdrawal on your own (Wesson, 1995).
- Need for a safe and substance-free environment—Some living situations are not conducive to your recovery goals. Perhaps you cannot trust yourself to stop using on your own because you have easy access to substances. Perhaps others that you live with are still using and that would interfere with your attempt to stop. Many people feel a need to leave their usual circumstances for a while and to take advantage of a setting that will keep them safe from substances for a period of time. Perhaps, too, you simply would appreciate being surrounded by supportive people as you begin your treatment and recovery process.
- Dual-diagnosis issues—Some have a mental health condition that is complicated by substance use and/or by withdrawal (Miller, 2012). People with issues like bipolar disorder or depression may have increased symptoms during withdrawal. Some find they need frequent contact with support that can help them monitor and manage their condition as they cut back or stop substance use. For some with severe mental health symptoms like suicidal feelings or hallucinations, more intensive settings are usually safer and more beneficial.
Some substances can cause severe reactions when they are stopped too suddenly, and complications such as respiratory distress, seizures, strokes, and even death can result without medical supervision.
Withdrawal and Detox
The withdrawal and detox process is a critical step in your alcohol or drug treatment and recovery if you choose complete abstinence as your goal. Abstinence is stopping use altogether—also referred to as cessation. If this is your recovery goal, you should consult very frankly with an addiction specialist about how to stop your use. Alcohol and drug detox centers understand that withdrawal can cause complications, including mild to severe discomfort and medical risks. An addiction specialist can help determine what you need for a safe withdrawal and detox. Some substances can cause severe reactions when they are stopped too suddenly and complications such as respiratory distress, seizures, strokes, and even death can result without medical supervision. In making your decisions about treatment, always err on the side of caution about withdrawal and detox. Get trained advice and make your plans from there.
Treatment Philosophies and Approaches
The addiction recovery field contains a wide range of philosophies and methods. All of them have had successes and failures. A great deal of the success of any method is how well it suits your individual needs, your personality, and your values and beliefs. Also, how much you will be able to stay with a treatment program, carry out the recommendations, and work the changes you need to make comfortably into your life will determine your chances of success or failure. Given these considerations, it is helpful to become acquainted with the alcohol, behavioral, or drug addiction treatment options available to you.
A significant aspect of harm reduction therapy is that abstinence is not required and clients are encouraged to set their own goals.
Harm reduction is sometimes part of addiction recovery services and can be found in several settings, including outreach and community-based efforts, as well as therapy. These services are designed to help people in all stages of addiction. For example, many community-based alcohol and drug rehabilitation programs focus on the immediate health risks of addicts who continue to use. They help addicts reduce their risks of HIV and hepatitis infection, as well as overdose (NHCHC, 2010) through needle exchange programs, access to primary healthcare, and education. Harm reduction programs like these help some addicts give up substance use altogether as they take a series of gradual steps to improve their health (NCHRC, 2014). Community-based harm reduction programs are especially helpful to those addicts who are homeless, have untreated mental illness, multiple health problems and refuse other treatment or are unable to obtain it.
Harm reduction therapy is a treatment approach that is done in therapeutic and counseling settings. For example, programs for alcohol addiction help you work toward controlled drinking or drinking in moderation, as well as complete abstinence (Logan & Marlatt, 2010). People are encouraged to review the negative consequences of their drinking. They then work with therapists to set goals to reduce the harm of alcohol in their lives. For example, people may choose goals such as drinking fewer drinks at one time, or drinking fewer days per week. A significant aspect of harm reduction therapy is that abstinence is not required and clients are encouraged to set their own goals.
Harm reduction therapy can seem to be radically different than other forms of treatment for addictions because abstinence is not required or encouraged by the treatment providers. People mistakenly believe, however, that abstinence is never a goal of harm reduction. "Both the abstinence model and the harm reduction model have similar goals…to create a better quality of life for the person receiving the service" (Martin, 2009).
The Pros of Harm Reduction
Some of the positive aspects of a harm reduction approach are:
- It acknowledges your right to make decisions about your substance use.
- It assists you with implementing any changes you want to make to reduce the harm of your use.
- It can reduce the health problems and risks involved with use.
- It can improve your hope, confidence, and ability to make better health decisions.
- It can lead to more beneficial steps and eventual abstinence.
- You can improve the quality of your life before you make a commitment to abstain totally.
The Cons of Harm Reduction
For some, there can be negative effects from the harm reduction approach:
- Some people are medically vulnerable and continued use can be fatal.
- Some individuals with mental illnesses can become progressively more vulnerable and at risk as they continue to use.
- Controlled use may not work for those who have few coping skills other than substance use.
- Cravings can be a problem. Even using small amounts of a substance can trigger binges for some people, causing them to use more than they intended.
- Not all substances can be cut down easily due to physical dependence and tolerance.
The Medical Abstinence Model of Addiction Rehabilitation
The medical abstinence model of alcohol or drug rehab is also sometimes called the disease model or simply the medical model. This approach considers addiction to be an illness—more specifically a brain disease—that is managed, or arrested, by stopping the use of substances (A.Noronha, Cui, Harris, & Crabbe, 2014). As with other physical conditions such as heart disease or cancer, addiction is associated with multiple types of causal factors and can become life-threatening if left untreated (Partnership to End Addiction, 2020). Addiction treatment centers that use the abstinence model emphasize the negative effects of use on brain functioning. Some of these effects are the brain's decreased ability to manage stress, memory, and learning impairments. Prolonged substance use is also thought to "teach the brain to crave drugs" (Angres & Bettinardi-Angres, 2008).
In this treatment approach, substance use is said to throw a "switch in the brain" as the result of prolonged drug abuse. "Initially, drug use is a voluntary behavior, but when that switch is thrown, the individual moves into the state of addiction, characterized by compulsive drug seeking and use" (Leshner, 1997). This suggests that once addiction is activated in the brain, a person cannot go back to voluntary and controlled use—that there is a loss of control when substances are used after the "switch is thrown." With continued use, the person can experience a significant loss in the ability to exercise self-control, which is the "hallmark of addiction" (NIDA, 2014).
For these reasons, the medical abstinence model encourages withdrawal and detox followed by learning how not to use addictive substances at all. Using substances again is considered a relapse of the illness from which a person might not be able to easily regroup. In short, any substance use is thought to be able to activate the brain's addiction process again.
The Pros of a Medical Abstinence Program
- Abstinence gives the body time to recuperate from substance use. It improves the ability to think more clearly and to make better decisions for one's well-being.
- Abstinence from substances is a significant health improvement.
- Abstinence programs get you over one of the most significant hurdles of recovery—the withdrawal and detox process.
- Cravings fade after a period of abstinence.
- Abstinence programs teach methods for remaining abstinent and for coping with life's stress without using.
The Cons of a Medical Abstinence Program
- Withdrawal and detox are necessary steps in this type of treatment.
- Not everyone succeeds in an abstinence program, and relapses can be discouraging.
- One is diagnosed with an illness and given labels such as "addict" or "alcoholic."
- Total abstinence may seem to be overwhelming if one does not have other coping skills.
- One's lifestyle may not support abstinence until some preparations have been made, like building a recovering support system, resolving housing issues, or getting better control of mental health condition(s).
The 12-Step Recovery Model
12-Step programs themselves are not treatment, but rather self-help recovery programs found in "anonymous-style" groups such as Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and Cocaine Anonymous (CA). 12-Step programs are considered spiritual programs and are based upon such principles as establishing a relationship with a "higher power" of your own understanding, using prayer and meditation to remain substance-free, helping others, and correcting one's behaviors and interactions (Alcoholics Anonymous, 2001).
12-Step programs can be found worldwide, and in larger cities meetings can be found scheduled around the clock. These meetings are free and open to anyone who has a desire to be substance free. Members remain anonymous to one another and focus upon their common problem and solutions to that problem. There is a series of steps that members work on as they progress in their recovery efforts. They consider themselves "addicts" or "alcoholics" who are "powerless" over their addictions.
12-Step programs are often part of established addiction recovery programs in rehab facilities. Many treatment centers recommend attendance and even hold meetings or take their clients to meetings in the community. In addition, many addiction rehab centers draw freely upon the principles of the 12 Steps in their counseling and therapy sessions. 12-Step programs follow an abstinence model and speak of addiction as an illness and disease. Much of the philosophy of medical abstinence treatment is similar to that of the 12-Step approach. They combine well and supplement each other.
12-Step programs can be found worldwide, and in larger cities meetings can be found scheduled around the clock. These meetings are free and open to anyone who has a desire to be substance free.
Alternatives to the 12 Steps
There are alternative self-help groups that do not use the concept of powerlessness or the labels of addict and alcoholic. They also do not use a spiritual approach. Some of these are listed below:
The principles of Rational Recovery (RR) have been incorporated into many alcohol, behavioral, and drug addiction help programs, just as 12-Steps principles have. Rational Recovery, however, was created as an alternative to the 12-Steps and RR literature discusses their differences at length. For example, RR does not consider addiction to be a disease. Unlike the 12 Steps that encourage abstinence one day at a time, RR encourages making a decision to stop using for the rest of your life through "planned, permanent abstinence". RR also considers addiction curable. Medical and 12-Step approaches posit that addiction only goes into remission, and relapses are possible (Trimpey & Trimpey, 1996).
This self-help program uses techniques from several psychological methods. These include cognitive behavioral therapy (CBT), rational emotive behavior therapy (REBT), and motivational enhancement therapy (MET). These methods help participants focus on 4 points of recovery: building and maintaining motivation; coping with urges; dealing with thoughts, feelings and behaviors; and living a balanced life (Hardin, 2013). SMART is used to supplement other recovery efforts and is used as the chief recovery resource for many.
Gender-Specific Self-Help Groups and Treatment Programs
Some addiction recovery centers and groups provide separate programs for men and women, recognizing that males and females often have different treatment needs. There are also self-help groups that are gender-specific. 12-Step programs, for example, offer women's meetings and men's meetings and there are groups like Women for Sobriety that are gender-specific. Women for Sobriety is for female alcoholics and is based upon the idea that women have different needs in recovery than men due to cultural issues and life experiences. It emphasizes empowerment, building personal strength to overcome addiction, and focusing on competence (Kirkpatrick, 2010). Similarly, in self-help groups and treatment programs for men, their unique life experiences and challenges in our culture are recognized as significant factors in their recovery efforts (Straussner & Zelvin, 1997).
Self-help groups typically have members who will greet new people and help make you feel welcomed and comfortable.
The Decision to Participate in Self-Help Groups
If you choose to get involved with a self-help group you can find contact information and meeting schedules online. Substance abuse treatment centers and other addiction recovery resources and groups often post their meeting schedules in local newspapers as well. Phone numbers for local groups can be also found in printed phone directories. You can make contact ahead of time with a group volunteer to ask about attending a meeting and what to expect. You can also find this information online. Many self-help groups also have online chats and meetings that you can easily find.
Self-help groups typically have members who will greet new people and help make you feel welcomed and comfortable. It is also common for members to identify themselves only by their first names. You can feel free to share as much or as little as you like in your first meeting if you are asked. Otherwise, it is usually a good idea to listen and find out how the program meetings work. After the meeting you may get information from other members about what they suggest you do next. Some may offer you their phone numbers in order to support you between meetings. Most groups also have literature for purchase so you can learn more. Many who participate in these groups also receive treatment through alcohol and drug rehabilitation centers or behavioral addiction centers.
The intake process will include an orientation to the facility and program.
If you have decided to enter an addiction recovery center or rehab program, there are certain things you can expect, regardless of the program's philosophy and approach. For example, in both outpatient and inpatient programs you will typically encounter:
An intake process—You are usually asked questions such as identifying information, information to confirm your insurance, and who you would like to have as emergency contacts. You may also be asked to give work and income information, or, if you have given these details on the phone, to verify the information.
You will have to sign documents that give the program permission to treat you, to talk with friends and family, and to get medical records from other settings. Also, you may be asked to fill out forms similar to what you might fill out at a doctor's office about your health history and the types of substances you have used.
The intake process will also include an orientation to the facility and program.
Assessment—The assessment (or evaluation) is done by a person who is trained in evaluating various aspects of your life and how you have been functioning. This is done to determine what your needs are and to make a plan for your alcohol, behavioral, or drug rehab treatment. You can expect to be asked questions about your mental health and substance use history (Tatarsky, Kellogg, & K.Witkiewitz, 2011). It is important to answer these as thoroughly and honestly as possible so that you can receive the appropriate care.
The assessment will also include information about your family, their health histories, and your current relationships. This helps the treatment team understand what support or stressors you have now and what health and addiction problems they have had. All of this is important to determine what you need and what conditions you may also be at risk for.
- Individual counseling—A therapist or counselor will be assigned to you with whom you will have private meetings to discuss all your treatment needs, recommendations, and other aspects of your recovery process.
- Education—Information about addiction and the recovery process is typically given in both individual sessions and groups or classes.
- Group counseling—Groups offer support from others in the treatment process, and an opportunity to learn about coping skills for your behavioral addiction or substance abuse recovery. You can expect discussions about common themes related to that process.
- Family counseling—Family sessions may be offered to enlist the support of loved ones in your recovery and to discuss the impact of addictions and recovery on the family.
- Referral for psychiatric services and medication if needed—If there are other issues that require assessment or treatment such as mental health conditions other than addiction, you can be referred to a psychiatrist for evaluation and possible medication to treat those conditions.
Because rehab is a safe and therapeutic environment, there are certain things you cannot take with you.
What You Need to Know If You Have Chosen Inpatient or Residential Addiction Treatment
To prepare for rehab there are certain simple steps to take. If you are using a referral or placement service, they will guide you through your preparation. Each facility will have specific instructions about what you need to do and your placement counselor can help you with these. Either you or your placement counselor will speak to someone at the facility to arrange admission.
As arrangements are made, you will need to have your insurance information available, if you do have coverage. Initial paperwork and insurance contact can be made before you leave home in order to ease your intake process. Also, because an addiction rehab center is a safe and therapeutic environment, there are certain things you cannot take with you. Typically, they include things that drugs and alcohol could be concealed in, but check with the specific facility. Some items to leave at home are:
- Opened containers of liquids, like personal care products
- Over-the-counter medications
- Food and beverages
Also, you may want to leave items of value such as expensive jewelry and credit cards, as well as larger sums of cash secured at home.
What to Take With You
- A few changes of comfortable and casual clothing (rehabs will have laundry facilities for your use)
- Weather-appropriate gear for your destination—jacket, coat, sneakers, boots, sunglasses, etc.
- Pajamas, robe, slippers
- Unopened containers of personal care items (if you have none, typically there are some provisions at the facility)
- Wallet with ID, insurance card, debit card, and money (check with the facility to see what is the recommended amount of cash to take)
- A list of contacts' names and phone numbers
- Bottles of medications you have been taking
- Electronic devices—phone, tablet, iPod—check to see which are allowed
Hope for Recovery
Even if you or a loved one is an addict, recovery is possible. Stay hopeful. Many people have changed their lives in significant ways by using addiction recovery steps and methods like those discussed above. We are fortunate to live in a time of so many choices. If you keep at it, you will find what works for you.
The process of getting to treatment is a significant one in your overall recovery process. Getting acquainted with various addiction treatments and rehab options, discovering what you want to change (and how you want to change it), and making preparations—all of this moves you much farther along on the path of recovery, even before you get to a self-help group or a treatment setting.
Find a Nearby Addiction Center
You can still get your life back. It's not too late to end your dependencies. Plus, many of the best addiction treatment centers offer great amenities to make your recovery as comfortable as possible.
A.Noronha, Cui, C., Harris, R., & Crabbe, J. (2014). Neurobiology of Alcohol Dependence [Kindle Edition]. Academic Press: London.
Alcoholics Anonymous. (2001). Alcoholics Anonymous, 4th Edition. New York, NY: A.A. World Services.
Angres, D., & Bettinardi-Angres, K. (2008, October). The Disease of Addiction: Origins, Treatment and Recovery. Retrieved 2014 October 29 from Resurrection Health Care.
Partnership to End Addiction. (2020). Is Addiction a Disease? Retrieved 2020 July 29 from Partnership to End Addiction.
Hardin, R. (2013). SMART Recovery 3rd Edition Handbook. Alcohol and Drug Abuse Self Help Network, Inc.
Kirkpatrick, J. (2010). Turnabout: New Help for Woman Alcoholic. Fort Lee, NJ: Barricade Books.
Leshner, A. (1997). Addiction Is a Brain Disease, and It Matters. Science 278: 45, 45-47.
Logan, D. & Marlatt, G. (2010). Harm Reduction Therapy: A Practice-Friendly Review of Research. Retrieved 2017, April 24 from National Center for Biotechnology Information (NCBI).
Martin, G. (2009). The abstinence verses the harm reduction model of addiction treatment contrasted. Retrieved 2014 October 29 from Hub Pages.
Miller, M. (2012). Dual Diagnosis: Drug Addiction and Mental Illness (Illicit and Misused Drugs). Broomall, PA: Mason Crest Publishers.
NIDA. (2014, October 27). What is Drug Addiction? Retrieved 2014 October 29 from Drugs, Brains and Behavior: the Science of Addiction.
Straussner, S., & Zelvin, E. (1997). Gender & Addictions: Men & Women in Treatment. Lanham, MD: Rowman & Littlefield.
Trimpey, J., & Trimpey, L. (1996). Rational Recovery: The New Cure for Substance Addiction. NY, NY: Pocket Books.
Wesson, D. (1995). Detoxification from alcohol and other drugs (Treatment improvement protocol). Washington, DC: U.S. Dept of Health and Human Services, Public Health Service, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment.