Addiction is a brain disease that is difficult to cure, but you should know that there are treatments that work. But while these treatments are effective at helping you achieve a level of control over the compulsive use of a substance, they don’t exactly cure you. Moreover, there is never a one-step solution to addiction because healing and recovery is a process.
The process of rehabilitation from any form of addiction is a long and very challenging one. It is, in fact, life-long. Plus, this process does not exactly follow the same fixed path for everyone and there is no absolute answer as to how it will go. Everything depends on the individual and one’s commitment to sobriety and recovery.
There is so much to know about the process of rehabilitation. This definitive guide to the rehab process will provide you with information on the various treatments available and will give you an idea of what to expect and how to go about recovery.
First Things First: What is Addiction
According to the National Institutes of Health – National Institute on Drug Abuse, addiction is a complex yet treatable disease affecting a person’s brain function and behavior. Abused substances can alter one’s brain structure and function, and this results in persistent changes that would affect the individual even long after the drug use has stopped.
This is the reason why addicts are at risk for relapse even if they have abstained from using a substance for a long period and even despite the potentially harmful consequences of substance abuse.
People can develop an addiction to substances including tobacco, alcohol, marijuana, inhalants like paint thinners and glue, PCP, LSD and other hallucinogens, opioid pain killers like oxycodone and codeine, heroin, sedatives, cocaine, methamphetamine, hypnotics and anxiolytics and other tranquilizer drugs to fight off anxiety, and other stimulants. Such substances can cause harmful changes in how a person’s brain functions.
Changes in the brain’s wiring cause people to get the intense craving for a particular substance and this makes it hard for them to stop using the stuff. Such changes can last long after the intoxication and the immediate effects of the substance. Intoxication manifests differently for each substance.
The worse thing about addiction is that, over time, people will build up a tolerance and they will need larger amounts of the substance to feel the effects or experience the intoxication. And while addicted people may be aware of their problem, they are unable to actually stop it even if they want to. In the long run, their addiction may cause issues at work, problems with family and friends, and health concerns.
Understanding the Basics of Addiction Rehabilitation
Rehabilitation is the process of restoring an individual to health and living a normal life again. It involves extensive therapy, where the main objective is to correct drug-seeking behaviors and to introduce and establish coping mechanisms. The rehab process also includes learning relapse prevention skills.
Various outlets of aftercare is also a part of an individual’s ongoing recovery. This aftercare will provide opportunities for continued relapse prevention and long-term support.
Who’s In Charge of Rehabilitation
Drug and alcohol rehabilitation treatment facilities help patients recover from addiction and substance use disorders. These facilities aim to rectify the patients’ maladaptive behaviors so they can make positive changes in their lives. Some drug rehab facilities help patients with specific drug addictions, while others provide a wider range of treatment services.
Treatment and rehabilitation are facilitated by a team of counselors and mental health professionals who will first evaluate the type of program that will suit your situation. However, before entering a rehab facility, you will have to undergo a detox process to rid your body of the addictive substance. A medical detox program involves medications to help manage your withdrawal, whenever appropriate, and this program is monitored by doctors and nurses.
After detox comes rehabilitation proper, and this phase provides you with an intensive therapy that allows you to examine the various underlying issues in your life that led to your addiction or substance use disorder. Therapy sessions are led by trained counselors.
A Tailored Rehab Program for You
The circumstances of your addiction are always unique to you. For instance, your triggers are different, and so are your coping mechanisms. As such, your treatment should also be unique and never a one-size-fits-all kind of thing.
An effective course of treatment and rehabilitation needs to be tailored to your specific physical and psychological needs to ensure your recovery. Moreover, an effective program will allow you to engage physically, mentally, and emotionally. In other words, for a rehab program to succeed, it should be holistic in its approach and should treat your whole person. After all, addiction affects every aspect of your life, so every aspect also deserves to recover and heal.
The Stages of the Addiction Rehabilitation Process
The process of rehabilitation involves three main phases, according to Steps Recovery Centers:
Intervention and Social Detox
The first stages will include social detox and intervention.
What is Intervention?
Rehabilitation always begins with an intervention. According to Narconon International, intervention is the process of getting an addicted individual to overcome their resistance to seek treatment.
Narconom explains that intervention, in most cases, is done by family members and friends who makes them realize that there is a problem, and then plead with the addicted individual to go into a rehab facility.
This is usually because the addicted individual has a low level of self-awareness and has blotted out the harms caused by their continued use of substances. These harms include damaged relationships, legal problems, financial ruin, health issues, and loss of employment.
Aside from lowered awareness, another reason why an addicted person may need intervention by others is that they may feel they are unable to deal with the sickness and pain associated with withdrawal.
Moreover, they may be driven by their cravings and need for a substance that they don’t think they could ever function normally without it. They may also have developed a low opinion of themselves after years of being addicted and, for some, of being involved in criminal activities.
For rehabilitation to take place, you first have to accept that a change needs to happen in your life and acknowledge that you need help in gaining back control over your physical, emotional, and mental health and well-being. Rehab requires that you or your family reach out and seek treatment from a treatment facility because you will never get admitted without your consent.
Intervention is a sensitive step toward rehabilitation, so credible treatment facilities always have a qualified intervention team to ensure that this crucial moment is handled with utmost care. This support team will be a neutral party and provide a voice of reason in the intervention process.
What is Detoxification?
Certain types of substance dependence can bring about withdrawal syndromes, and the symptoms can range from unpleasant to dangerous. Rehab patients who are at risk of developing these withdrawal syndromes can benefit from strict monitoring and supervision.
In cases where the symptoms are severe and potentially fatal, pharmacologic intervention through medical detox becomes necessary and the safest route to take to help ease these withdrawal symptoms.
Before detoxification, you will be evaluated by a professional medical practitioner to determine your withdrawal risks and the probability of you having a complicated withdrawal. From this, you will also know the specific types of medical interventions you need to mitigate these withdrawal risks during detox.
Withdrawal Symptoms Expected While in Detox
According to the American Addiction Centers, the severity and the precise duration of withdrawal from addictive substances depends on a lot of factors, including what particular substance was used and the magnitude of a patient’s dependence on that substance.
Withdrawal from alcohol and benzodiazepines have high health risks, heroin and petrol withdrawal have moderate health risks, while cannabis, amphetamines, ecstasy, and nicotine have low health risks.
Acute opioid withdrawal syndrome, for example, can include symptoms like anxiety and nervousness, trouble sleeping, diarrhea, hot and cold flashes, flu-like symptoms, nausea, excessive sweating, and muscle cramps or body aches.
And while these symptoms are not exactly life-threatening, the mere discomfort can bring about physical and psychological distress. For cocaine withdrawal, a patient may experience depressed mood, irritation, psychotic episodes, thoughts of self-harm, hallucinations, and lethargy.
Severe withdrawal symptoms, on the other hand, include increased heart rate and delirium tremens, which may happen among alcoholics. This symptom is manifested through fever, seizures, extreme agitation, extreme confusion, high blood pressure, and tactile, auditory, and visual hallucinations. As such, strict monitoring by medical professionals is necessary.
When it comes to withdrawal management, medical detox provides patients the safest and most comfortable setting. You can safely rid yourself of all the toxic influences of drugs and alcohol under the care of medical professionals who will monitor your vital signs like blood pressure, check for high body temperature, and administer medications.
Social Detoxification vs. Medical Detoxification
Not to be confused with medical detox, social detox is when your withdrawal from any substances is supervised, monitored, and managed through therapy and counseling and without any use of detox medication, or at least not yet. This is done first to determine whether the withdrawal process is manageable and not life-threatening and without any form of medical intervention.
Social model detox is cost-effective since it does not require immediate medical care or inpatient medical monitoring. Because medical detox or full-on medical care takes place within a hospital setting and patient monitoring and supervision are done by doctors and trained medical staff, it could be costly.
However, considering that, at this stage, the withdrawal symptoms can still become severe and can still happen at any given time, social detox still involves the close monitoring of patients. The primary goal of social detox is a concern for safety, understanding, physical and emotional nourishment, and keeping the patient away from drugs. Even without medication, social model detox can be highly effective and can help patients gain long-term sobriety.
Whether it is social or medical detox, the goal is to reach a state of comfort and safety for your mental and physical stability.
Diagnosis and Customized Care
This phase includes the assessment and intake process, which involves a consultation with a professional regarding your treatment options. You will also get to discuss which particular approach would work best for you and your specific situation. The goal for this is to develop a customized treatment plan that is based on your medical, social, and emotional functioning evaluation.
As such, during the intake process, the rehab facility’s treatment team performs an extensive assessment that includes psychological and psychosocial assessments, as well as a medical examination. The evaluations also involve looking into your personal drug use history and the history of addiction in your family.
You will also discuss financial arrangements for your treatment. All the information gathered in the assessment process will help the treatment team determine how to best tailor your rehab program to you and your unique needs.
Co-Occurring Disorders and Dual Diagnosis
If you have certain medical issues or if you have a co-occurring disorder or dual diagnosis, additional treatment options will be discussed. This will ensure that you receive the right amount of care and the appropriate level of support during the rehabilitation period.
Dual diagnosis is when a person is experiencing both substance misuse and mental health problems. This term is also referred to as co-morbidity and co-occurring mental illness and substance use.
A dual diagnosis could include the following examples:
- A mental health issue or disorder that is associated with or leads to problematic use of drugs or alcohol
- A substance use disorder that is associated with or leads to a mental diagnosis
- Alcohol or drug use disorder that worsens or alters the course of one’s mental illness
Different patients have different experiences of dual diagnosis. It mainly depends on the type of mental health issue and its associated symptoms, as well as on the drug or alcohol used. Different combinations of the two have different outcomes, and how your body reacts to this mental-illness-and-used-substance combo presents a whole different factor, too.
For instance, one might experience anxiety or depression when drinking alcohol while another may find that smoking weed worsens their paranoia. It also depends on the level of support and treatment a patient receives. Because while some types of treatment would work for some patients, they may not be as effective for others.
Inpatient and Outpatient Care
Customer care involves both inpatient and outpatient treatment. While there are many types of alcohol and drug treatment programs, they generally just fall into one of two categories: inpatient or outpatient programs. Both the patients and their loved ones must understand the differences between the two before they decide on a treatment option because finding the right treatment is the key to sobriety.
An inpatient program is an intensive, residential treatment that is designed to help with serious addictions. This means that a patient stays in the rehab facility while undergoing addiction treatment. It also includes medical detox and continuing care. This category of treatment aims to remove patients who are struggling with substance use disorder from their old ways by taking them out of a potentially problematic home environment, then placing them into a treatment facility with round-the-clock care from staff.
An outpatient program, on the other hand, is a part-time program that allows a patient to keep going to school or to work during the day. Outpatient treatment includes day treatment, general outpatient, intensive outpatient, transition treatment, and sober living.
This treatment category is a good option if you have familial or work obligations like caring for elderly parents or children as it allows you to keep meeting these responsibilities. Outpatient care is ideal for those who have a mild or short-lived addiction. However, it is not optimal for those who have a serious, long-term addiction or dual diagnosis conditions.
After completing a successful detox and effective withdrawal management, you and your treatment team can now focus on your longer-term recovery through the main rehabilitation phase. Rehabilitation proper consists of a series of therapies and various treatment efforts. It involves extensive counseling that allows you to understand and address all the underlying issues that have propelled you towards addiction.
Being able to confront and address the issues that led to your addiction will help you effectively move on with your life. This means you no longer go back to alcohol, drugs, and other substances, or resume your addictive behaviors.
Even after you have completed your initial rehabilitation or treatment program, you are not yet finished with recovery work. That’s because recovery is a lifelong process. And even before you complete your program, you will meet with your counselors to discuss your aftercare plan.
It is important to build a solid aftercare plan, whose individual components may differ from one individual to the next. And the good thing about this is that rehab facilities offer their follow-up programs to assist you as you resume your daily life outside. Aftercare programs may consist of meetings, additional counseling, and classes for alumni of the rehab program.
There are also sober living facilities, where patients can live for a while together with other recovering individuals.
Principles of Effective Treatment
The NIH-NIDA explains that there is no single appropriate treatment for everyone. The treatment used for patients depends on the type of substance they have abused and on their behavioral characteristics. Appropriate treatment also considers a patient’s age, gender, culture, and ethnicity.
Moreover, treatment settings, services, and interventions are matched to a patient’s particular issues and needs. Doing this effectively has a lot to do with the patient’s ultimate success in being able to productively function again within the workplace, the family, and society in general.
Treatment also has to be readily available for it to be effective. Addicted individuals are usually uncertain about submitting themselves to a treatment program, so the treatment services must be available for them to be able to take advantage of them whenever they are ready.
Potential patients may be lost if the treatment is not readily accessible. They will only have excuses not to go through with it. Additionally, the earlier the treatment is offered to an addict, the better his or her chances of recovery.
Other principles of effective addiction treatment include:
- The treatment has to attend to a variety of needs and not just focus on the substance abuse. For a treatment to be effective, it also needs to address any medical, social, psychological, and legal issues associated with drug abuse.
- A patient needs to remain in treatment for an adequate amount of time. The appropriate length of treatment is also not absolute; it depends on the patient’s problems and needs. The NIH-NIDA says research indicates that the most addicted persons need a minimum of three months in treatment to reduce or stop their substance abuse. The longer the duration of the treatment, the more successful the outcomes.
- Behavioral therapies are the most common forms of addiction treatment. Behavioral therapies, which include individual, family, and group therapy, vary in their focus. These therapies may involve addressing an individual’s motivation to change, building skills to resist the use of a substance, facilitating better interpersonal relationships, providing incentives for abstinence, improving problem-solving skills, and replacing drug-use activities with activities that are rewarding and constructive.
- Medications are an important factor in treatment, especially when combined with behavioral therapies. For example, buprenorphine, methadone, and naltrexone are effective in helping patients addicted to opioids as these meds get patients to stabilize their lives and reduce their illicit drug use.
- Medically assisted detox is only the first stage of rehab treatment. Detox, by itself, does very little to change one’s long-term drug abuse. And although medically assisted detox safely manages acute physical withdrawal symptoms and can pave the way for effective long-term treatment, it is rarely sufficient in helping a patient achieve complete recovery. Patients should continue with treatment after detoxification.
- Treatment doesn’t have to be voluntary to be effective. The ultimate success of a treatment may also be influenced by family intervention and encouragement of loved ones. Employment settings and even the criminal justice system may also force one to enter a rehab program, and eventually recover.
- The use of drugs during treatment has to be monitored continuously. Knowing that their use of substances is monitored can serve as a powerful incentive for patients and it can help them fight the urge to use drugs. Monitoring also gives an early sign of a return to drug use and signals a need to adjust one’s treatment plan to better meet one’s needs.
- Treatment programs should require that patients be tested for infectious diseases. Patients need to be tested for the presence of hepatitis B and C, HIV/AIDS, tuberculosis, and other potentially infectious diseases as drug-related behaviors put them at risk for these diseases. They should also be provided with targeted risk-reduction counseling so they can further reduce or avoid high-risk behaviors. What’s more, counseling can help patients who are already infected to properly manage their illness.
Different Behavioral Therapies Used in the Rehabilitation Process
A drug rehabilitation facility applies several types of therapy for their patients.
In individual therapy, you undergo individual drug counseling with your counselor. Your main objectives are to address the symptoms of your addiction and to identify the areas of your life that have been affected by substance abuse. In other words, you get to do some self-analysis and look back to the time you first started using the substance and the reason behind why you started misusing that substance.
Your counselor will recommend strategies for you to redirect your time and put it to better use and will teach you time management skills, which are very essential in your ongoing recovery. You will also learn how to identify drug use triggers, as well as how to deal with these trigger situations so you can avoid a relapse.
This type of behavioral therapy will help reform your thinking patterns. It will also help you make behavioral changes directed at living a healthy, sober life.
Most addiction rehab facilities incorporate family therapy in their treatment program. In this type of therapy, your family members are encouraged to participate in therapy sessions to help resolve issues. This way, your family can become better equipped at being your pillar of support once you leave the rehab facility.
The rehabilitation process typically includes group therapy. And these group sessions are the mainstay of many rehab programs now. This is because a counseling session in a group setting allows those who are recovering from addiction to interact with and gain inspiration from others who are in the same situation as they are.
It would be helpful for you to know that you are not alone in your struggles. Group therapy provides a sense of community support, which is important and integral to the recovery process.
Living a Sober Life Post-Rehab
To keep substance-free or sober, you will still need to follow many extra steps post-rehab. Being in remission means that you need to get regular checkups and do a lot of maintenance work to keep yourself in recovery mode.
For one, many patients still maintain regular group therapy sessions. Some even submit to regular, scheduled drug testing to keep themselves accountable in their sobriety. Attending group therapy regularly is a good way to build a support system in your community post-rehab.
These group therapy sessions include Narcotics Anonymous (NA) and Alcoholics Anonymous (AA), both well-known groups that hold meetings throughout the United States. Many people who are recovering from alcoholism and addiction attend these group meetings regularly.
Another way to remain free of addiction is to abstain from using any of the addictive substances. The habitual use of something other than the substance you were originally addicted to can easily pose a threat to your sobriety status as your brain is still prone to propel into a mode of dependency.
Rehabilitation from addiction never really ends. But it is very feasible to have a life that is free from the hold of alcohol, drugs, and other addictive substances. Furthermore, it is possible to not have any form of addiction in your life ever again.
Keep in mind that the cure for addiction is only possible if you keep yourself in remission for the rest of your life. This cure can come from your desire to change in a good way.