With the ongoing opioid epidemic, many people who live in the United States are at a much higher risk of addiction than in previous years.
Drug abuse and drug treatment cost the United States roughly $740 billion a year, according to the National Institute on Drug Abuse (NIDA). The opioid epidemic has ensnared an unprecedented number of people into addiction and death through overdose.
For example, from 1999 to 2017, more than 700,000 people died from drug overdoses overall, reports the U.S. Centers for Disease Control and Prevention (CDC). Yet, of that number, nearly 400,000 have died from an overdose involving any opioid in that same span.
On average, about 130 Americans die every day from an opioid overdose, states the CDC. The situation is so acute that for the first time ever, an American is likelier to die from an opioid overdose than from a motor vehicle crash, according to the National Safety Council.
It’s not just opioids that have been enacting carnage across the U.S. landscape. In 2019, media reports indicate that amid the relentless opioid epidemic, there has been a resurgence in meth use across the country as well.
According to the CDC, the number of meth-involved overdose deaths skyrocketed by more than 250 percent between 2011 and 2016, from 1,887 to almost 7,000.
Drug addiction is a public safety concern that enacts an incalculable toll on individual lives, families, and entire communities. To combat addiction and death, it is essential that addicted persons seek immediate professional help.
The longer one waits to seek treatment, the more havoc the addictive substance can wreak on the body and mind. Essentially, drug rehabilitation can save a life.
Drug rehabilitation is when someone with a substance use disorder engages in medical and psychological therapy to combat and treat their disorder. Substance use disorder (SUD) is a diagnosable condition recognized in the medical community as a chronic, long-lasting disease.
NIDA defines addiction as a chronic relapsing disorder of the brain marked by compulsive drug-seeking and drug use despite adverse consequences. Addiction also inflicts lasting and profound changes to the brain.
Although it is a disease, there is no single “cure” for addiction. Fortunately, substance use disorders are treatable conditions that prolonged drug rehab can help.
The clinical term substance use disorder encompasses drug dependence and addiction. The American Psychiatric Association (APA) publishes the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition(DSM-5), which serves as the principal authority for psychiatric diagnoses and establishes the criteria for whether someone has an SUD.
According to the DSM-5, if a person displays two of the following symptoms over 12 months, they may have a drug addiction:
Drug rehabilitation centers generally feature a large variety of different therapy and treatment methods, which are intended to determine the root of addiction and to prevent further abuse. Depending on the severity of the addiction, an addict may participate in inpatient (living at the facility) or outpatient (living off-site) treatment programs.
When it comes to battling addiction, choosing the right drug rehab center is essential in ensuring the comfort and overall success of rehab.
While every addiction is a separate case and should be treated as such, the process of treating addiction generally follows the same overall structure, rarely changing with the type of substance.
That structure is outlined in the American Society of Addiction Medicine (ASAM) levels of care.
The different levels of care provide patients access to a range of treatment steps, and the wide variety of methods offered can make rehab effective, appropriate, and efficient.
Once someone enters a drug rehab program, they are immediately placed under supervision and care.
As time passes, a patient will be granted more freedom and less medical supervision as they progress through treatment. By encouraging clients to work their way toward these freedoms and privileges, treatment centers can teach clients responsibility and relapse prevention skills.
The following comprise the broad levels of care in drug rehab, as outlined by ASAM.
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As the first step in drug rehab, medical detoxification (detox) is one of the most important steps in treating almost all substance addictions.
Because chronic drug abuse and addiction can lead to physical dependency and changes in the body, detox is essential as it removes all residue and leftover toxins from the addictive substance.
By slowly tapering off a substance and substituting the abused substance with a properly-administered medication, a doctor can nullify the substance dependence in a patient.
With the removal of all substance and substance residue, the brain of the patient will become chemically unbalanced. As a result, the patient may become physically and mentally ill due to the side effects associated with substance cessation and detox.
Not only are these withdrawal symptoms uncomfortable, but they can sometimes prove fatal. Medical detox is designed to help ease the withdrawal symptoms and ensure the client’s comfort. With the assistance of an experienced team and the application of necessary medications, professional treatment facilities can ensure a safe and effective detox process.
Upon arrival, the patient is evaluated and diagnosed by our team members to decide which steps to take in treatment. This includes the formulation of a specialized detox plan that will best avoid withdrawal symptoms while also being the most effective in long-term relapse prevention.
After the successful completion of detox, the next step for someone in recovery may either be inpatient/residential treatment or an outpatient program.
Inpatient care encompasses intensive inpatient programs and residential treatment programs. Clients are required to live on-site at a treatment facility for both short-term and/or long-term residential treatment.
By living on-site, the patient is provided an environment in which they can focus primarily on recovery, disregarding those outside distractions and temptations that may cause relapse or introduce anything detrimental to recovery.
To ensure successful inpatient treatment, all focus must be directed toward making the patient feel as comfortable and confident as possible.
While someone is in intensive inpatient treatment, they will have a full-time schedule of therapy established for them.
Because drug addiction can be difficult to treat, many centers have established a carefully developed curriculum to maximize rehab effectiveness.
Therapists work with people in recovery to help the latter get to the root of their addictions. By educating themselves on the psychological underpinnings of their abuse and addiction, a patient can work with a therapist to create a long-term relapse prevention plan. This can heighten the chances that treatment is a success.
Inpatient treatment not only allows clients the ability to interact with doctors and case managers, but they will also get to know others who are seeking treatment for similar addictions. While the overall process may vary depending on the drug rehab center, the most integral aspects of treatment remain steady throughout most facilities. Plus, social interaction is among the main reasons why inpatient treatment can be healthier and more fruitful than outpatient.
It’s worth noting that in terms of duration, NIDA recommends a 90-day stay or more in a residential program to maximize treatment effectiveness.
Inpatient/residential treatment is tailored to clients with severe cases of addiction. Outpatient, on the other hand, is for clients with milder cases who may require a less-intensive process and have a stable living environment at home.
Outpatient is a term used to describe any type of treatment that requires a patient to participate in therapy at a center but allows them to live off-site.
The different levels of outpatient care are known as partial hospitalization program (PHP), intensive outpatient (IOP), and routine outpatient (OP).
Partial hospitalization is the first level of outpatient. To be classified as a PHP entrant, the client must undergo therapy at least five days a week on a nearly full-time schedule.
What distinguishes PHP as an outpatient program is very simple; the client is not required to live on-site. After a day of treatment, they can return to housing non-affiliated with the treatment center.
This off-site housing gives the clients more freedom to interact with their community without jeopardizing the success of treatment.
IOP is the next step down under outpatient. To be classified as intensive outpatient treatment eligible, the client must attend between nine hours and 20 hours of treatment per week, depending on the severity of the addiction.
Intensive outpatient programs operate on a part-time schedule, allowing the patient to maintain multiple personal responsibilities such as school and work while undergoing rehab.
The final level of outpatient treatment is called routine outpatient, or OP, which will usually last longer than PHP or IOP, typically six months.
However, routine outpatient generally requires about an hour a week for therapy. At this point, it is expected that the patient is at a relatively stable state in their lives and recovery. Thus, the level of clinical intervention is minimal. OP is merely a means to provide additional support when a patient is transitioning from drug rehab back to everyday life.
Rehab is not over once you complete treatment. While it may be true that the hardest part is over, it is critical to remain vigilant so that you do not relapse. To solidify your sobriety, we suggest you partake in an aftercare program to help you ease back into society after rehab.
A common method employed in drug rehab is aftercare administered through outpatient programs.
Outpatient programs are a perfect solution to aftercare once a patient finishes inpatient or residential treatment.
Most reputable and established treatment programs aim to address the mental and emotional aspects of addiction, not just the substance itself. That’s why clients are provided with a range of therapy approaches, from evidence-based treatment to alternative therapies.
The following treatment models are offered in rehab:
Cognitive behavioral therapy (CBT): A type of talk therapy where you tackle the false or negative thinking around your substance abuse. CBT helps you clearly view abuse and addiction in order to choose the most effective response.
Dialectical behavior therapy (DBT): DBT equips you with coping skills to address the events, thoughts, feelings, and behaviors around substance abuse.
Motivational interviewing (MI): This counseling approach helps you explore and resolve feelings of ambivalence around substance abuse. A therapist will help you find the motivation to make needed changes in regard to your addiction.
Contingency management (CM): CM implements positive reinforcement and stimulus control to reward positive responses to substance use and addiction.
The catalyst behind the worst drug epidemic this country has ever seen typically requires detox and the application of approved treatment medications to help wean a patient off the addictive drug. For opioid addictions, clients are typically administered medications such as methadone or Suboxone.
The reason is that the abrupt stoppage of opioids can unleash painful withdrawal symptoms that can drive a person to relapse, putting them at risk for a potentially fatal overdose. Severe cases of opioid addiction can be recommended for inpatient and outpatient treatment. Outpatient is reserved for milder cases.
Along with alcohol, benzodiazepines can generate life-threatening withdrawal symptoms once someone abruptly stops using. In detox settings, medicines can be administered to help facilitate the benzo tapering process. A client may be switched from the addicting benzo to a less potent drug to establish the weaning process. The withdrawal symptoms that arise are treated by a medical team.
As with other substances of abuse, clients can enter residential or inpatient, depending on the severity of their case.
Meth withdrawal is not considered life-threatening, but this drug can generate intense psychological effects. Because meth use can produce ruinous, life-threatening health conditions like brain disease, heart disease, and severe gum and tooth decay, detox and residential or intensive outpatient treatment are necessary to address the profound psychological impact of this stimulant drug. Therapeutic approaches like cognitive behavioral therapy (CBT) and contingency management (CM) are effective in treating meth addictions, states NIDA.
American Society of Addiction Medicine (ASAM). (2018, July 20). What are the ASAM Levels of Care? Retrieved from https://www.asamcontinuum.org/knowledgebase/what-are-the-asam-levels-of-care/
Centers for Disease Control and Prevention. (2018, December 19). Opioid Overdose. Retrieved from https://www.cdc.gov/drugoverdose/epidemic/index.html
Hedegaard, H., M.D., Bastian, B. A., Trinidad, J. P., M.P.H., Spencer, M., M.P.H., & Warner, M., Ph.D. (2018). Drugs most frequently involved in drug overdose deaths: the United States, 2011–2016 [PDF File]. Hyattsville, MD: National Center for Health Statistics. Retrieved from https://psychcentral.com/addictions/substance-use-disorder-symptoms/
National Institute on Drug Abuse. (n.d.). The Science of Drug Use and Addiction: The Basics. Retrieved from https://www.drugabuse.gov/publications/media-guide/science-drug-use-addiction-basics
National Institute on Drug Abuse. (n.d.). 7: Duration of treatment. Retrieved from https://www.drugabuse.gov/related-topics/trends-statistics
National Safety Council. (n.d.). For the First Time, We're More Likely to Die From Accidental Opioid Overdose Than Motor Vehicle Crash. Retrieved from https://www.nsc.org/in-the-newsroom/for-the-first-time-were-more-likely-to-die-from-accidental-opioid-overdose-than-motor-vehicle-crash