Recovering from drug addiction can represent a new start in life, especially if the individual has access to a strong support system and a comprehensive treatment program. The first step in helping a friend or family member start the healing process is to find a drug treatment center that provides individualized care for the complex disease of addiction. Effective treatment includes a continuum of recovery services that support the client from the detox phase through therapeutic rehab, aftercare planning, and relapse prevention.
Watching someone you care about struggle with addiction to cocaine, meth, heroin, or any other drug can be emotionally devastating. Drug treatment programs can also offer support to the family, spouses, or partners of individuals recovering from addiction. In your search for a facility, look for a program that provides counseling and education to the client’s loved ones. Having that source of support will help to rebuild relationships, restore trust, and create a healthier environment for everyone at home.
Recognizing the Need for Treatment
Even if you’ve noticed the signs and symptoms of drug abuse in someone close to you, it can be hard to admit that a loved one has a substance abuse problem. Many of us hope that the behavior will resolve itself with time, or that the friend or relative will stop using when he or she isn’t under so much stress. However, statistics show that addiction is a widespread, progressive disease that almost always gets worse without treatment and recovery activities.
The National Survey on Drug Use and Health from 2013 provides the following facts about drug use in the United States:
- Nearly 25 million Americans age 12 and older abused illegal drugs in 2013.
- There were close to 23 million Americans who needed treatment for drug or alcohol abuse or dependence that year.
- Out of those who needed treatment, only 2.5 million were treated at a facility that specialized in addiction recovery.
- Approximately 3.2 percent of American adults (7.7 million) had a co-occurring mental illness and substance use disorder.
Drug abuse isn’t a reflection of a poor character or a bad upbringing. Addiction is a chronic condition that is characterized by uncontrollable urges to use the drug of choice, frequent relapses, and continued use in spite of the negative consequences. Unfortunately, the statistics from the NSDUH indicate that only about 10 percent of these individuals receive the kind of treatment they need to recover from addiction.
Convincing a Loved One to Get Help
Many people who are addicted to drugs refuse to enter treatment because they don’t believe they have a drug problem. They may be convinced that they can stop using any time they want, or that they are abusing drugs for valid reasons, like self-medication for pain. If your loved one refuses to accept the need for rehab, a formal intervention may be necessary to get him or her into a treatment program. Many drug treatment facilities offer intervention services or referrals to therapists who specialize in arranging and conducting these meetings.
With the support of other friends and relatives, and a professional trained in addiction treatment, it is possible to break through denial and persuade a loved one to go to rehab. Taking this step can be very difficult, but intervening in a loved one’s drug addiction could literally save his or her life.
Warning Signs of Drug Addiction
How can you recognize the signs of addiction in someone close to you? A person who is using drugs will display unusual changes in personality, habits, or values. The person might start hiding things from you, telling lies, or stealing money. Favorite activities and old relationships are often neglected in favor of new habits and “cooler” friends. Here are some additional red flags to watch for:
- Secretive behavior
- Unexplained mood swings
- Sharp fluctuations in energy levels
- Sleeping too much or too little
- Increased anxiety or restlessness
- Pinpoint pupils
- Wearing sunglasses after dark
- Pale, cool, or sweaty skin
- Unusual rashes, bruises, or scabs on the skin
- Upset stomach, nausea, or vomiting
- Unwanted weight changes
- Needle marks on the arms or legs
- Thoughts of suicide or self-destructive behaviors
- An increased preoccupation with using prescription drugs, especially pain relievers, tranquilizers, and sleeping pills
Illicit drugs like heroin and meth are no longer the most common drugs of abuse in the US. Prescription narcotics can be just as dangerous as street drugs if they are abused for nonmedical reasons. The U.S. Department of Health and Human Services reports that the number of overdose deaths related to opioids like oxycodone, hydrocodone, hydromorphone, and morphine quadrupled between 1999 and 2013.
Some of the most obvious signs of drug abuse are actually withdrawal symptoms. When an addict suddenly tries to quit using or doesn’t have access to the drug of choice, the body and brain go into a state of withdrawal, causing symptoms that may resemble a cold or flu. Cravings for the drug will intensify, and the individual may become agitated or depressed. Drug treatment programs offer medically supervised detox services, which ensure the safety and comfort of clients as they go through these unpleasant symptoms.
Root Causes of Addiction
What causes someone to become addicted to illicit drugs like cocaine, heroin, or meth, or to abuse prescription medications? There are many biological, social, and psychological factors that can predispose a person to addiction, including the following:
- Imbalances in brain chemistry: Drugs like heroin, methamphetamine, cocaine, marijuana, and prescription narcotics cause sensations of pleasure or euphoria by influencing the chemicals that make up the brain’s natural reward system. Many illicit drugs increase levels of dopamine, a neurotransmitter that creates feelings of contentment, or norepinephrine, which triggers feelings of energy. People who have unusually low levels of these chemicals may seek out drugs in order to feel happier, less anxious, or more “normal.”
- Genetic makeup: Some of the factors that make certain people vulnerable to drug abuse may be passed from one generation to the next. Mayo Clinic notes that there are certain hereditary neurological traits that may contribute to the disease of addiction.
- Living environment: The behaviors, beliefs, and values of the people around us affect our own decisions, especially during the formative years. Children who are raised in a household where at least one adult abuses drugs are more likely to experiment with drugs and to develop chemical dependencies than those who are not exposed to substance abuse.
- Traumatic experiences: Substance abuse often represents an effort to erase violent or painful memories, if only temporarily. People who have been abused or exposed to violent crimes, wars, or natural disasters have higher than average rates of drug and alcohol abuse. For these individuals, recovering from drug addiction requires some form of trauma therapy to process and release those traumatic memories.
- Co-occurring mental illness: A large percentage of individuals with drug abuse problems also suffer from one or more forms of mental illness, such as depression, bipolar disorder, post-traumatic stress disorder, or schizophrenia. The Substance Abuse and Mental Health Services Administration states that as of 2014, approximately 18 percent of American adults with mental illness also had a substance use disorder, compared with only 6 percent of Americans who were not mentally ill.
Understanding the root causes of drug addiction may make it easier to relate to a loved one who has a substance abuse problem. Addiction is not the result of a character flaw or a lack of self-discipline, but a brain disease that is comparable in severity to other serious chronic illnesses, such as heart disease, diabetes, or cancer.
Levels of Drug Treatment
Addiction treatment consists of a series of steps, starting with the removal of drugs from the client’s system and progressing to higher levels of physical health, inner strength, and self-sufficiency. A drug treatment program should encompass a range of treatment services to make the transition from one step to the next as seamless as possible.
Comprehensive treatment programs include the following levels of care:
- Medical drug detox: In this critical stage of treatment, clients are stabilized medically as the toxins are cleansed from their bodies. This cleansing process strengthens the body and readies the mind for rehab.
- Inpatient rehab: Inpatient rehab includes 24-hour monitoring by clinical staff in a secure, supportive setting. Clients benefit from a variety of therapies, including individual therapy, support groups, 12-Step meetings, family counseling, and medication management.
- Residential treatment: At residential treatment facilities, clients live onsite at a dedicated rehab center while participating in therapeutic modalities such as Cognitive Behavioral Therapy, trauma and grief therapy, Motivational Interviewing, group therapy, and 12-Step meetings.
- Partial hospitalization programs: Also known as PHPs, these programs combine the structure of inpatient treatment with the increased autonomy of an outpatient program. PHPs offer intensive recovery services up to seven days a week, but clients live in their own homes or sober living houses.
- Intensive outpatient care: In an intensive outpatient program, or IOP, clients take part in recovery activities and therapeutic modalities during the day, while returning home at night. IOPs provide a structured environment for recovery without the restrictions of round-the-clock monitoring and supervision.
- Aftercare planning: Maintaining a sober lifestyle after rehab is one of the biggest challenges of recovery. Aftercare services encourage and motivate clients to practice their new coping skills in a community environment, while providing a support system that helps to sustain their sobriety.
Many of the therapeutic services offered in drug treatment — including individual therapy, Cognitive Behavioral Therapy, medication management, 12-Step groups, and trauma therapies — can be offered in an inpatient or outpatient setting. If a client is ready for the autonomy of outpatient rehab, this level of care can be just as effective as inpatient treatment.
A study published in Substance Abuse Treatment, Prevention, and Policy showed that outpatient rehab services were just as beneficial to participants as residential treatment programs. After six months in substance abuse treatment, clients in an intensive outpatient program showed similar improvements to those who received inpatient care. As long as the client receives treatment that is appropriate for the severity of the individual’s drug use, outpatient and inpatient treatment can be equally valuable. The most appropriate form of treatment should be assessed on a case-by-case basis.
Locating a Facility
Drug treatment programs are available in every major city in the United States and in many smaller communities. The National Institute on Drug Abuse estimates that there are over 14,500 specialized substance abuse treatment programs in the US alone. Recovery programs are offered in a wide range of settings, including hospitals, correctional centers, religious organizations, public health centers, and private rehabilitation facilities. In fact, there are so many treatment options available that it might be overwhelming to compare all your options.
Your choice should be based on your loved one’s needs and the needs of your family. As you narrow down your choices, talk with admissions counselors at these facilities to find out whether the program and its services meet your requirements.
Here are a few of the key factors to consider when you compare drug treatment centers in or around your community:
- Location: Some clients prefer to remain close to home while they recover, with easy access to their support systems. For others, going out of state is a better option, giving them distance from the stresses and triggers that contribute to their addiction.
- Level of supervision: Clients with a recent history of severe drug abuse may be safer in a program that offers 24-hour medical detox and rehab. This level of treatment, known as inpatient care, provides a comfortable, structured environment around the clock. On the other hand, clients who are very motivated and who have work or family obligations may be ready for a partial hospitalization program (PHP) or intensive outpatient program (IOP), which allows them to live at home while attending recovery sessions at the facility several days per week.
- Recovery services and therapies: Drug treatment programs have changed significantly in the 21st century, and so have the therapies and services provided by drug rehab centers. Today’s therapists use an approach called Motivational Interviewing, or MI, to encourage the client in recovery and strengthen self-esteem. Cognitive Behavioral Therapy, or CBT, teaches clients new strategies for coping with life’s stressors and avoiding relapse. Trauma therapies, 12-Step meetings, family counseling, nutritional analysis, recreational therapy, and many other services are available to clients in drug rehab. Look for a facility that offers a comprehensive range of services to support recovery.
- Staff credentials: The staff at a comprehensive drug treatment facility should include medical professionals (doctors, nurses, health techs), mental health experts (psychiatrists, psychologists, therapists), addiction counselors, nutritionists, dietitians, and therapists representing a wide range of disciplines. Staff members should be highly educated and credentialed, offering experience in both addiction treatment and mental health services.
- Facility certifications: Treatment centers are regulated by the agency that oversees alcohol or drug rehab programs in any given state. These agencies ensure that the programs and the centers themselves meet standards of safety and effectiveness. The facility should also be accredited by a national agency that ensures excellence in addiction treatment. Look for a facility that is accredited by the Commission on the Accreditation of Rehabilitation Facilities (CARF), an organization that promotes quality service in drug and alcohol treatment programs.
- Accommodations and amenities: The facility you choose should provide an environment that supports physical and psychological healing. Attractive accommodations, a serene setting, indoor gyms, and luxury amenities help create an environment of comfort and safety for clients seeking to overcome addiction. Gourmet meals and spa services contribute to overall health and encourage clients to remain in treatment, even when the work of rehab gets challenging.
- Forms of payment: Many private and publicly funded drug treatment centers accept health insurance, as well as private payment. Some facilities will even arrange payment plans that accommodate the client’s resources. Private facilities that offer research-based therapies, comfortable accommodations, and spa-like amenities can be surprisingly affordable, so it’s important not to overlook these options when you’re conducting your research.
- Aftercare services: A drug treatment program should not end once the client leaves the facility. Aftercare services help the client make the transition from life in rehab to life in the community through sober living homes, alumni programs, and referrals to local 12-Step groups or recovery organizations.
Understanding the Intake Process
The intake process represents a pivotal stage in rehab. At this point, the client has taken the first steps in entering a program, and the treatment team must determine what type of care will best meet that individual’s needs. Intake involves much more than gathering demographic information or processing payment.
The client should undergo a complete physical, psychiatric, and psychosocial assessment, including:
- Level of recent substance abuse
- Types of substances used
- Previous rehab experiences
- Current medical condition and past medical history
- Potential mental health concerns (undiagnosed psychiatric illness)
- Current psychiatric diagnoses
- Family and relationship status
- Home environment
- History of past trauma
- Social support system
- Occupational status and financial resources
During the intake process, the treatment team determines what level of care the client needs to remain stable, safe, and comfortable in recovery. A large part of this decision is based on the client’s medical and psychiatric condition, severity of substance abuse, and motivation to seek treatment. Clients who have serious co-occurring conditions or who are at high risk of abandoning treatment may be treated most effectively in an inpatient setting, such as a hospital program or residential rehab facility. Medically stable clients who are strongly committed to recovery and who don’t need 24-hour supervision may be ready for partial hospitalization or an intensive outpatient program.
The information gathered during the admissions process also allows the treatment team to develop an individualized treatment plan for the client. During the initial assessment, for example, staff can determine whether the client needs treatment for a co-occurring psychiatric disorder, such as depression or post-traumatic stress disorder. The team can identify the type of recovery services the client may need, such as trauma therapies, 12-Step facilitation, or nutritional counseling. In addition, psychosocial needs can be identified, such as the need for marriage or family counseling.
Having a strong support system has been identified as one of the greatest protective factors against relapse after drug treatment. After finishing a drug rehab program, clients can continue to rely on a support network that includes members of their treatment team, family and friends, and their peers from the rehab center. Aftercare planning is a vital component of any comprehensive drug treatment program, as this service helps to maintain sobriety when the client is back in the community.
Some of the activities recommended in an aftercare program include:
- Joining an alumni program for graduates of the drug treatment program
- Attending local 12-Step meetings
- Participating in recovery organizations
- Volunteering for public service groups
- Staying in a sober living environment
Sober living homes act as a bridge between rehab and life in the community by providing a drug-free environment where residents can practice their new coping skills. Life in these homes is structured by a series of rules that support sobriety, yet residents have a great deal of independence and freedom. Attendance at regular meetings, adherence to a curfew, and participation in household chores are required at most sober living houses.
A study of 245 recovering individuals dwelling in sober living homes found that after six months, 12 months, and 18 months, these residents had shown improvement in several key areas of recovery, including alcohol and drug use, employment, criminal behavior, and psychiatric symptoms. This study, published in the Journal of Substance Abuse, indicates that residents of sober living environments are more likely to avoid relapse than those who rejoin the mainstream community immediately after rehab.
Relapse prevention is one of the primary goals of an aftercare program. Clients in aftercare are encouraged to practice their alternate behaviors and newly acquired coping skills as they confront the challenges of life in the community. Sustaining long-term sobriety is not a matter of luck or chance, but the result of commitment and effort on the part of the recovering individual and loved ones. An effective drug treatment program gives its clients the tools they need to sustain the benefits of rehab long after leaving the facility.