Addiction Treatment: Types of Treatment Programs
AAC offers a full spectrum of drug addiction treatment programs for adult men and women, based upon individual needs as assessed through comprehensive evaluations at admission and throughout participation in our program.
All Clients are Unique
Your individualized addiction plan is customized according to the addiction severity, presence of a co-occurring mental health disorder, and your unique needs.
Medical DetoxDepending on the drugs in your system, you may need to go through a detoxification process, or “detox.” Medical Detox is our highest level of care and involves round-the-clock medical monitoring of the withdrawal process to ensure your body safely heals from chemical dependency.
Safe WithdrawalDuring this process, which typically lasts 5-7 days, our medical team provides 24/7 supervision for safe withdrawal as substances slowly exit the body. We also address any medical issues and administer the appropriate medications if clinically necessary.
Our treatment facilities work with local healthcare providers to assess the unique detox needs of all clients. Once clients are medically cleared, our staff transports them to their specified residential treatment setting that is staffed 24/7 for medical monitoring.
For the safety of you or your loved one, all medications are kept in a secure location that remains locked at all times. At the appropriate dosing times, clients administer their own medications with one of our behavioral health staff present. In case of non-life threatening emergencies or to report changes in a client’s mental, physical, or emotional status, we have physicians and providers on-call to assist.
“Without professional supervision and medication to mitigate withdrawal symptoms, the risks of detox health complications and relapse substantially increase.”
Residential Treatment (RT)Clients enter residential treatment, (sometimes known as inpatient treatment), once they are medically cleared and physical withdrawal symptoms have stabilized. Residential clients at our facilities are monitored 24/7 for their safety.
Our staff ensures that residential clients are actively involved in treatment. This includes consistent attendance at groups, individual sessions, and 12-Step meetings. Along with addiction care, our co-occurring focus addresses mental health issues as part of our integrated treatment. Co-occurring issues commonly treated are depression, bipolar disorder, anxiety, PTSD, and other trauma conditions.
Partial Hospitalization Program (PHP)
Our PHP level of care provides you or your loved one with structured addiction treatment at least five days a week for a minimum of six treatment hours each day. Clients participate in customized treatment according to their needs consisting of daily programming, regular group therapy, and weekly individual therapy sessions.
Clients enjoy greater access to the surrounding sober community with the opportunity to attend outside 12-Step meetings, while learning to have fun in recovery through recreational activities and experiential therapies. The purpose of PHP is to move clients away from around-the-clock supervision to gain more real-life experience in the community.
Intensive Outpatient Program (IOP)IOP addiction treatment is the least restrictive of our programs, and provides you or your loved one with care three days per week, with a minimum of three treatment hours each day.
Clients in IOP have greater access to the community and if scheduling permits, are able to continue their employment and other personal obligations. The focus of our IOP is to reintegrate individuals into society while we further collaborate with them on developing aftercare plans, exploring employment opportunities, and preparing them for the next step in their recovery.
Medical Detox at American Addiction Centers
Detoxification is an essential step in the addiction treatment process. A Medical Detox program helps you or your loved one safely stop using the substance(s) of abuse by removing residual toxins caused by the body’s physiological dependence on the drug(s) in a safe, medically-supervised setting. While both drug or alcohol detox can be physically unpleasant at times, without this process toxins may remain in the body and continue to cause cravings, psychological and emotional distress, medical issues, or other complications. Since substance use causes changes in the body’s biochemistry, it takes time, professional supervision, and individualized treatment to recover and restore equilibrium.This biochemistry component of the addiction disease is why professionals and medical research strongly recommend that individuals seek supervised detox services instead of quitting cold turkey. Without professional supervision and medications to mitigate withdrawal symptoms, the risks of health complications and relapse substantially increase.
Furthermore, studies by the Substance Abuse and Mental Health Services Administration (SAMHSA) show an there is an increased risk of fatal overdose when individuals relapse during this period just after detox due to the body’s shift in lowered drug tolerance levels.
How Detox Works at AAC
Step 1: On-Site Assessment
When clients walk through our doors, they are greeted by staff and escorted to a private area for discussion, assessment, and completion of paperwork. This initial on-site assessment helps determine the needed intensity of treatment services and level of care based on their presenting symptoms and conditions.
Step 2: Clinical Assessment
Based on the assessments’ findings, within 24 hours of admission clients undergo additional assessments that include a medical history, psychological evaluation, and physical. At this time, if there is a need for medications to help reduce or eliminate any withdrawal symptoms, our nurses obtain orders from licensed physicians.
Step 3: Tapering Programs
Tapering protocols signify approximately how long the drug detox or alcohol detox program will last, and the pace at which daily dosages of detox medications will be reduced. Detox tapering protocols are started according to physician’s orders. Withdrawal Experiences are Unique It is important to emphasize that each person’s withdrawal experience is unique based on:
- Substances used – Amount, frequency, and method
- Tolerance level – Increased or decreased
- Addiction severity – History and progression
- Co-occurring conditions – Mental health, medical, and chronic disease
Step 4: Transition to Treatment
The National Institute of Drug Abuse (NIDA) reports that the longer the time between an individual’s detox and admission into a residential treatment program, the greater the risk of relapse. It is for this reason that following completion of our detox program, clients immediately transition to one of our addiction treatment programs.
I’m afraid to enter treatment because I don’t want to go through withdrawal. What should I do?
There’s no reason to be afraid of treatment. Detox and withdrawal can be challenging but our facilities that provide on-site detox are staffed with licensed medical teams that will closely monitor you for signs and symptoms of withdrawal. By progressing through the detox progress, withdrawal symptoms tremendously diminish.
What is the detox environment at American Addiction Centers like?
For the sake of clients going through detox at AAC facilities, we’ve located our detox rooms away from the main client activity areas. This promotes a quiet environment that helps clients – especially during peak days of their withdrawal. However, theses detox rooms are close to staff offices for frequent monitoring and easy access to staff. Because American Addiction Centers specializes in dual diagnosis—simultaneously treating substance abuse and behavioral health issues—our licensed psychiatrists are available during the detox process to address high levels of stress or anxiety.
Finding Help for Addiction Treatment
The two main categories of addiction treatment are inpatient and outpatient rehabilitation. Within these settings, recovery programs may vary in their treatment philosophies and therapeutic approaches. Some therapies that are commonly used to treat addiction include:1
- Cognitive-Behavioral Therapy.
- Community Reinforcement Approach.
- The Matrix Model.
- Contingency Management.
- Motivational Enhancement Therapy.
- Family Behavior Therapy.
Treatment plans will differ from individual to individual. No person’s path to recovery will be identical to another’s.
Can Drug Addiction be Treated?Addiction is a chronic condition characterized by intense drug cravings and compulsive substance use regardless of the negative effects. Long-term substance abuse may result in major changes in brain function—affecting areas involved in behavioral-control, memory and learning, and motivation and reward.2 Chronic drug use also often leads to physiological dependence on the substance; once you’re dependent, you’ll experience distressing withdrawal symptoms when you attempt to quit. These withdrawal symptoms often contribute to continued substance abuse, as people may use the drug in order to alleviate the unwanted symptoms or postpone their arrival altogether.
As a result of all these neuroadaptations (changes in the brain), addiction is often relapsing, which means that some people may initiate their recovery after completing treatment, return to drug or alcohol abuse, then attend treatment again, repeating this cycle many times. Relapsing is considered a normal and common setback in the recovery process.2
Substance abuse treatment programs provide comprehensive treatment for addiction, but they do not offer a “cure.” A cure implies that the person is no longer afflicted by a condition once they complete treatment—after treatment, a person may be sober but will still need to manage their addiction throughout their lives using the tools they learned in rehab.
When an individual is treated for addiction, they receive a combination of interventions, such as individual therapy, group counseling, family therapy, and medication, if applicable. These interventions are aimed at rectifying drug-using and maladaptive behaviors and replacing them with healthy and positive behaviors.2 Further, someone being treated for a substance use disorder will be evaluated for any possible co-occurring mental health disorders (known as a dual diagnosis), such as depression, anxiety, post traumatic stress disorder (PTSD), personality disorders, or schizophrenia. If they are diagnosed with a psychiatric condition, the treatment plan will ideally be created to reflect care that integrates both addiction treatment and appropriate mental health interventions. Addressing both of these conditions during treatment increases the chance of having a positive treatment outcome.3
Addiction can absolutely be treated, but just a few days or months of abstinence isn’t typically enough to make lasting behavioral changes.2 Instead, professionals view recovery as an ongoing process that requires long-term support and relapse prevention training. Because of this, people are encouraged to participate in aftercare after they’ve completed a rehab program.
Aftercare treatment can include self-help groups (such as SMART Recovery), 12-step meetings (such as Narcotics Anonymous), alumni programs, sober living homes, individual therapy, and group counseling.
What Makes an Effective Treatment Program?
It’s important to understand that no single treatment type is appropriate for everyone. That is why it’s crucial that every treatment program has a mental health or addiction professional conduct an intake evaluation before creating an individualized treatment plan according to the patient’s unique needs.4
A professional biomedical and psychosocial evaluation can assess and record:5
- Physical status and neurological functioning.
- Medical history.
- Mental status.
- Vital signs, such as temperature and pulse.
- Patterns of drug or alcohol abuse.
- Results of urine test for substance use.
- Previous detox or addiction treatment experiences.
- Demographics such as age, ethnicity, and level of education.
- Living conditions, transportation, legal status, dependent children, and financial situation.
- Risk of violence or suicide.
- Cognitive, sensory, or physical disabilities.
Once an assessment is performed and a treatment plan is created, the treatment team must re-assess the individual on an ongoing basis in order to modify the plan as needed.4 This ensures that the patient is receiving the most effective treatment for them throughout the recovery process.
What Are Evidence-Based Therapies?
Evidence-based therapies are interventions that have a significant body of research supporting their effectiveness in treating addiction. Some of them may be more beneficial in treating addictions to specific drugs than others. Below is a list of commonly used evidence-based therapies and the types of substance abuse they treat:6-11
- Cognitive-Behavioral Therapy (CBT): This therapy is commonly applied to the treatment of many addictions, including those to alcohol, marijuana, cocaine, and methamphetamine. The therapist analyzes the connection between behaviors, feelings, and thoughts, and helps the patient to identify and fix their negative patterns in order to quit using drugs and prevent relapse. Patients use skills learned in CBT to cope with triggers and stressors related to drug abuse.
- Contingency Management (CM): CM is often used to treat people recovering from an addiction to stimulants, marijuana, alcohol, and opioids. Treatment staff members provide patients with tangible rewards (such as cash prizes or vouchers, food, or other goods and services) for exhibiting positive behaviors and proof of drug abstinence, such as providing a substance-free urine sample.
- Community Reinforcement Approach (CRA): This is a 24-week program people attend on an outpatient basis. It is typically used to treat addictions to cocaine or alcohol. This program consists of intensive weekly therapy and counseling sessions in which the patient builds relapse prevention skills, receives vocational training, engages in new recreational activities, and builds new social networks. Much like CM, patients receive vouchers for providing substance-free urine samples a few times per week. A computer-based version of this type of therapy, called Therapeutic Education System, has been demonstrated to be effective in treating opioid and stimulant addiction.
- Motivational Enhancement Therapy (MET): This type of therapy, which is commonly used to treat alcohol or marijuana addiction, helps to increase a person’s motivation to make a positive change in their life by entering substance abuse treatment. The therapist assesses the patient, collaborates to build a plan for change, instills coping skills, and encourages commitment to abstinence. This type of therapy isn’t necessarily intended to help a person quit but rather to encourage a transition into a comprehensive addiction treatment program.
- The Matrix Model: This type of therapy is primarily used to treat people addicted to stimulants, such as cocaine and methamphetamine. The Matrix Model combines several other treatment approaches and includes group therapy, family counseling, drug education, self-help participation, and relapse prevention strategies. Other components of treatment include recovery skills groups, family education groups, 12-step programs, social support, relapse analysis, and urine tests.
- Family Behavior Therapy (FBT): FBT not only addresses problems related to drug and alcohol abuse, but it also aims to treat other issues, such as family conflict, unemployment, depression, child mistreatment, and conduct disorders. This type of therapy involves at least one significant person in the patient’s life, whether it be a parent, romantic partner, or sibling, and combines family therapy with contingency management. The counselor helps the patient and significant other in improving their interpersonal skills at home. Also, behavioral goals are set and then if they’re met, the significant other in treatment will provide the patient with a reward or voucher.
Are Medications Part of Treatment?Many programs combine behavioral therapy for addiction treatment with medications approved by the Food and Drug Administration (FDA) to manage withdrawal and/or help maintain recovery in the long run.
Medical detox is a group of interventions intended to manage withdrawal and achieve medical stability. Medications are often crucial in assisting a person during this uncomfortable and sometimes painful process. Medications can help to reduce cravings, mitigate withdrawal symptoms, and prevent complications. Not all substance withdrawal syndromes can be treated with detox medications, however; for example, there are no medications specifically approved for managing stimulant dependence and withdrawal. In some cases, medical professionals may administer supportive medications, such as antidepressants.
There are several medications available for the management of opioid and alcohol withdrawal. These include:5
- Methadone: This full opioid agonist is capable of displacing heroin and prescription painkillers at the opioid receptors in the brain. By interacting with and activating these receptors, methadone helps to re-stabilize certain brain functioning, mitigating opioid withdrawal symptoms and cravings to increase the person’s comfort during withdrawal. Methadone is relatively long-acting, which facilitates a controlled, daily dosing schedule. Since it is an opioid, it does have potential for abuse.
- Buprenorphine: This partial opioid agonist also displaces opioids of abuse at the opioid receptor sites and alleviates opioid withdrawal and cravings. As a partial agonist, buprenorphine has a ceiling to its effects—including its potential for achieving a subjective, rewarding high—which helps to minimize its abuse potential. Compared to methadone, it may produce a lesser-pronounced euphoria. Buprenorphine is frequently formulated in combination with naloxone to further deter abuse.
- Clonidine: This non-opioid drug is often used in combination with other opioid detox medications to manage the autonomic arousal symptoms of opioid withdrawal, such as high blood pressure and rapid pulse.
- Benzodiazepines: Benzodiazepines, including Valium and chlordiazepoxide, are the preferred class of medications to manage acute alcohol withdrawal. Because benzodiazepine use can lead to dependence, the doctor will create a gradual tapering schedule for you in which you slowly reduce your dose over time.
- Phenobarbital: Barbiturates were once commonly used to treat alcohol withdrawal, but they have high abuse potential and can quickly lead to tolerance. Overdose is also a concern with these drugs. Phenobarbital is still in use but only in very supervised environments, such as in a hospital.
- Anticonvulsants: These have proven to be effective in managing mild to moderate alcohol withdrawal symptoms. They are not controlled substances and don’t have any abuse potential, which is helpful when treating someone with a substance addiction.
- Antipsychotics: These drugs help to control delusions, hallucinations, and agitation during alcohol withdrawal. Some of these medications may lower the seizure threshold, so this is something that the treatment team needs to take into consideration when evaluating the patient’s risk of withdrawal seizures and delirium.
Once you complete a detox program,* you’ll likely transition into a substance abuse treatment program in which medications may be initiated or continued.
The combination of behavioral therapy and medication is known as medication-assisted treatment (MAT). The term is typically used in reference to opioid addiction treatment, but it may also refer to treatment for alcohol abuse as well.12
People who complete a rehab program often want to continue taking a medication for an extended period of time to decrease opioid cravings and reduce their risk of relapse. Methadone can be used in the long-term as a maintenance medication to promote abstinence. Some people may take it for a few months, while others may take it for years and even a lifetime. This medication can only be dispensed via a certified opioid treatment programs (OTP), commonly called a methadone clinic.12
A combination medication, Suboxone, which contains buprenorphine and naloxone, is often used during opioid addiction treatment and afterward to relieve cravings. The opioid effects hit a “ceiling” at a certain point, which helps to ward off abuse. The naloxone has no effect when Suboxone is taken as directed (orally), but if the drug is dissolved in solution and injected, the opioid antagonizing properties will induce opioid withdrawal. Similar to methadone, this medication can be used for as long as the patient is comfortable. Unlike methadone, Suboxone can be prescribed by physicians in an office-based environment by a Suboxone-licensed doctor.12
Naltrexone, another medication used in MAT, is a non-addictive opioid antagonist, which means that it blocks the effects of prescription painkillers and heroin at opioid receptor sites, preventing the addictive high. This works to deter people from abusing opioids since they can’t experience the desired effects.12 Naltrexone also blocks some of the associated euphoric effects of alcohol and may be used in the treatment of alcoholism, once acute withdrawal has resolved.12
Disulfiram is another maintenance medication used in the treatment of alcoholism. It should be given after a period of abstinence or detox. This medication deters drinking, because a person will experience unpleasant effects if they drink while taking this medication. These effects may include flushing, sweating, headache, racing pulse, nausea, and vomiting.12
Acamprosate is an alcohol dependence medication that can be taken for an extended period of time. It may reduce the desire to drink in people who are recovering from alcoholism. Initiation of acamprosate should be delayed until 5 days after the last drink.12
*NOTE: Detox will not be required for everyone; your doctor can discuss with you whether this step is needed.
What Else Can I Expect?
During inpatient addiction treatment, you can expect a highly structured environment with around-the-clock monitoring and supervision. Your treatment team may consist of several, variously qualified practitioners. They may include addiction counselors, psychiatrists, medical doctors, nurses, and other professionals, depending on the treatment program’s philosophy and offerings.
Evidence-based therapies, as discussed above, will make up the core of treatment; however, some holistic treatment programs may integrate traditional treatment approaches, such as psychotherapy, with complementary and alternative therapies (CAM). These CAM therapies may include:13
- Meditation and mindfulness.
- Recreational therapy.
- Music therapy.
- Guided imagery.
These CAM therapies are often used in holistic programs as part of a “whole-person” approach, in which the treatment staff aim to heal the mind, body, and spirit.
Every treatment program is different, so it’s important to do your research when searching for a program that is an appropriate fit for you. Other treatment components that may be included are:
- Recovery meetings, such as Narcotics Anonymous, SMART Recovery, or Secular Organizations for Sobriety (SOS).
- Life skills training, which can provide people with real-world skills, such as resume-writing, applying for jobs, and social skills.
- Drug education, which can teach patients about the effects and dangers of drugs and common drug combinations.
- Vocational training, that can help you build the skills you need to transition into a career after rehab while still receiving the therapy you need to stay sober as you make this transition.
Just as each program offers varying services and therapies, they also differ in amenities. For instance, luxury treatment programs provide patients with an upscale setting and luxurious services, such as massage therapy, spa treatment, gourmet meals, golf, equine therapy, etc. People in luxury treatment typically have their own private rooms, while many other standard inpatient programs may require that patients share a room. If quality amenities are high on your life of treatment priorities, you’ll want to ask each rehab what they have to offer and what the recovery environment is like.
The number one rule is always a zero-tolerance policy for drugs and alcohol.
Many treatment programs have rules that you’re required to follow while you’re enrolled in their program. The number one rule is always a zero-tolerance policy for drugs and alcohol. You must remain abstinent while attending addiction treatment. As stated before, some may require that you have a roommate. Others may forbid cell phones and other electronics, such as iPads or laptops. Some programs allow visitors on a set schedule, while others don’t allow visitors either at all or for a certain period of time at the start of treatment. Occasionally, a rehab may allow pets to stay with you during your treatment, but this is very rare.
How Long Does Addiction Treatment Last?
There is no one set timeline for the duration of addiction treatment. It will largely depend on your unique needs and situation as well as your recovery progress. Many inpatient programs offer a range of 30 to 90 day treatment, although it can be extended on an as-needed basis. According to the National Institute on Drug Abuse (NIDA), residential or outpatient programs that are shorter than 90 days may have limited effectiveness, and longer bouts of treatment are generally associated with better treatment outcomes.14
The program length and required daily time commitment for outpatient treatment varies according to the intensiveness of the program. Partial hospitalization programs, or day treatment, may require many hours of treatment per day, most days of the week, while intensive outpatient programs require a few hours per session for a couple days per week. Relatively lower-intensity outpatient programs may require meeting once or twice a week for 1-2 hours each session. The duration of each program ranges according to the patient’s addiction severity, treatment needs, and other individual factors.15
As a general rule of thumb, the longer a person receive substance abuse treatment, the better. This includes both primary treatment and aftercare, or follow-up support.14
Since addiction is a relapsing condition, many people find that they return to drug or alcohol abuse, particularly when faced with certain triggers or stressors. Although not everyone relapses, it is still considered to be a normal part of the recovery process and indicates that they require another course of treatment, possibly with a different approach.16
It’s crucial that someone recovering from a drug or alcohol addiction remain focused on recovery and regularly attend some form of ongoing support, whether it be support group meetings or therapy appointments.
What If Polydrug Use Is a Factor?
Many people who seek treatment for addiction struggle with polydrug abuse, meaning that they may be dependent on more than one substance. This means that they are likely to experience multiple withdrawal syndromes when they abruptly quit using. Some common substance combinations include:5,17
- Alcohol and cocaine.
- Alcohol, cocaine, and heroin.
- Heroin and cocaine.
- Alcohol and marijuana.
- Benzodiazepines and alcohol.
- Benzodiazepines and opioids.
- Ecstasy and alcohol.
Of course, there are several other commonly abused substance combinations. When a person arrives at a detox facility, it’s important that the professional conducting the intake evaluation adequately assesses for polysubstance abuse. Some people may be hesitant to admit to polydrug abuse, even if they disclose a problem with one particular substance.
Sometimes people aren’t even aware that they are using multiple substances, as many dealers cut their drugs with other drugs to keep costs down. Other times a person entering detox or treatment may not believe that they are addicted to or dependent on one of the substances, so they fail to disclose using this substance.5 For these reasons, the intake professional must conduct interviews with loved ones to determine the full extent of the patient’s drug abuse. The patient should also receive a urine drug screening to confirm each substance of abuse.5
It can be extremely difficult to predict how multiple drugs will interact and impact withdrawal, so the treatment team typically determine how they will detox the patient by prioritizing the substances of abuse according to the severity of the person’s dependence and the expected withdrawal syndromes. Doctors will prioritize management of the most severe withdrawal syndromes first, which are those associated with alcohol, sedative-hypnotics, and opioids.
The substances that are known to have the most dangerous withdrawal symptoms associated with them include alcohol and sedatives, such as benzodiazepines and barbiturates. Withdrawal from opioids (such as heroin and painkillers) also tends to produce very unpleasant symptoms and in some cases, medical complications.5
Polysubstance abuse should be factored into treatment beyond detox, as well. It’s important to conduct a thorough assessment, evaluating all the drugs used, mental health status, medical history, physical health, socioeconomic factors, and previous detox and treatment experiences, in order to create a treatment plan that fully addresses each problem.
Different types of therapy are beneficial for different substance addictions, so an ideal treatment plan may include a combination of therapeutic interventions that promote abstinence from all substances. The treatment team may conduct ongoing evaluations of the patient throughout the program. Doing so allows them to do constant check-ins to ensure that the therapies are working. If they don’t appear to be helping the patient, then the treatment plan may be adjusted accordingly.
Treating Concurrent Drug and Behavioral Addictions
Sometimes drug addictions co-occur with behavioral addictions. This is just one example of what is sometimes referred to as a dual diagnosis. Behavioral or process addictions, such as gambling addiction, are characterized by compulsive engagement in a behavior or activity despite the negative impact these behaviors may have on various parts of a person’s life. Much like substance addictions, people with behavioral addictions have lost control of their problematic behaviors. Co-occurring drug and behavioral addictions can fuel each other, which complicates both evaluation and the treatment process.
One study consisting of 6,000 individuals found that more than half of the participants reported past-year problems with one or more drugs or behaviors in the study. About 30% of people had a problem with one behavior or one substance, about 13% experienced 2 problems, and nearly 8% experienced problems with 3 or more drugs or behaviors.18
The behavioral addictions included in the study were:18
- Video gaming.
Gambling is the only one of these problematic behaviors included as a non-substance-related disorder in the DSM-5, while others, such as sex, pornography, compulsive internet use, and shopping, are still being studied.22
The research on comorbid behavioral and drug addictions is limited, so some treatment centers will be better suited to treat these patients than others. There are specific treatment centers that specialize in treating the unique needs of co-occurring substance and behavioral addictions, so it’s important that you do thorough research before choosing a program. Integrated treatment for several addictions is vital, because failure to identify and address every addiction is associated with worse treatment outcomes.18
Treating Addiction When Mental Illness Is Present
Commonly, drug addiction occurs alongside a mental health condition. The co-existence of these two conditions can also be referred to as a dual diagnosis. According to the Substance Abuse and Mental Health Services Administration, an estimated 8 million adults in the United States had a dual diagnosis in 2014.3 Those with psychiatric conditions are more likely than people without them to develop a drug or alcohol addiction, and vice versa.3 In fact, about 45% of people seeking treatment for a substance addiction are diagnosed with a mental disorder.19
Co-occurring conditions can be challenging to diagnose due to the complex manner in which the symptoms interact. Sometimes people receive treatment for one disorder while the other one goes unaddressed. The failure to adequately treat both conditions can be dangerous, as the ramifications of untreated co-occurring disorders may contribute to suicide, physical illnesses, incarceration, homeless, and even premature death.3
There are several posited theories as to why these conditions commonly co-occur. One major theory is that of self-medication. This means that people with a mental disorder that pre-dates the drug addiction may take drugs to alleviate the unwanted symptoms of their mental illness. This may work temporarily and, thus, reinforces continued drug use, which ultimately leads to a problematic cycle of abuse and addiction.20 If a person doesn’t receive adequate care that addresses the mental health condition, relapse may be more likely, because drugs may be their only coping mechanism for this disorder.
Much like the treatment of co-occurring addictions and behavioral addictions or polydrug addictions, mental health treatment must be integrated with substance abuse treatment in order to produce best outcomes. Integrated treatment works best when many treatment professionals, such as addiction specialists, mental health counselors, doctors, nurses, etc. collaborate on the treatment plan and throughout the recovery process. The treatment team’s outlook should be patient-centered, creating a plan that is most appropriate for that individual and their goals.19
How to Address Comorbid Medical Conditions
Addicted individuals often present with comorbid medical conditions resulting from their chronic substance abuse. Some medical conditions commonly encountered in those with certain substance use disorders include:5,21
- HIV: A user may contract HIV from sharing needles or engaging in risky, unsafe sexual practices.
- Hepatitis: Much like HIV, an individual could contract hepatitis from sharing needles or having unprotected sex with others.
- Skin infections: These may also occur as a result of intravenous drug use.
- Sepsis: This is a dangerous infection that spreads throughout the entire body from its origin.
- Liver problems: Liver damage or disease may result from chronic alcohol abuse or prescription painkiller abuse (those containing acetaminophen). Left unmanaged, hepatitis can also lead to severe liver damage.
If you are an intravenous drug user, there are ways in which you can reduce the risk of harm. You can receive regular testing for HIV, hepatitis, and other communicable diseases on a regular basis. You can also avoid sharing needles with others, or you can find a needle exchange program near you. These programs provide access to sterile needles to help reduce the risk of contracting an infectious disease. Of course, the healthiest and safest course of action is to receive formal treatment for your addiction.
During detox, it is particularly important that the treatment team effectively evaluate and diagnose any co-occurring medical conditions so that they can keep the patient safe during the withdrawal process. If someone has liver damage, for example, this may change what medications they are administered during detox.5
Some drug treatment programs specialize in treating addiction when a medical condition is present. These facilities are staffed with doctors, nurses, and other treatment professionals to ensure your safety and provide you with 24-hour supervision and access to medical treatment. When you enter a treatment program they will assess for any co-occurring medical conditions so that they can create an individualized treatment plan that incorporates adequate care for such issues.5
Treatment for Pregnant WomenPregnancy is a significant medical concern that necessitates care from an experienced treatment program. Many pregnant women may fail to receive the addiction treatment they need due to shame associated with using drugs during pregnancy. They may also avoid treatment due to the fear of Child Protective Services (CPS) taking their child once he or she is born or removing other children from the home.5 For these reasons, it’s crucial that the detox and addiction treatment staff members are supportive and compassionate during this trying time for pregnant patients.5
A pregnant woman with significant substance dependence must enter a program that is equipped to handle the challenges of detoxification in addition to substance abuse treatment. Before providing the patient with any medications, they must receive informed consent regarding the risks and benefits of taking these medications. The treatment team should also provide pregnant women with wraparound services available to them once they give birth, such as shelter, medical clinics, food, facilities that assist with physical or developmental problems resulting from drug or alcohol exposure.5
Ultimately, regardless of your specific situation, addiction, or treatment barriers, the best thing you can do for your health and happiness is to find a detox and addiction treatment program that suits your unique needs. The search for the right program for you may seem overwhelming at first, but writing down a list of treatment priorities can help you to narrow down your search.
Substance Abuse Clinics
Substance abuse clinics are private establishments or hospital departments that offer drug addiction treatment programs in a safe recovery setting. These clinics provide therapeutic interventions and other clinical services to help individuals overcome their dependence on alcohol and other drugs.
Services provided at substance abuse clinics may include medically supervised detoxification, inpatient treatment, residential treatment, partial hospitalization programs, outpatient treatment, and medication assisted treatment.
Is drug addiction a medical condition?
Yes, addiction is classified as a disease by most medical associations. The American Society of Addiction Medicine defines addiction as a “treatable, chronic medical disease” that will require continued monitoring and treatment throughout an individual’s lifetime.23
What is substance use disorder?
Drug addiction, also called substance use disorder, is a diagnosable medical condition characterized by an inability to control the use of illicit drugs, legal recreational drugs, or prescription medications.24 Various genetic and environmental factors modify an individual’s risk for the development of a substance use disorder.25 This disease can significantly impair one’s health and well-being and will often require specialized substance abuse treatment.
How is substance use disorder diagnosed?
The diagnosis of a substance use disorder requires a thorough evaluation and assessment by a psychologist, a psychiatrist, or a licensed alcohol and drug counselor.24 Mental health professionals and addiction specialists in the United States typically base their diagnosis on criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a publication from the American Psychiatric Association that is used by clinicians and researchers to diagnose and classify mental disorders.26
What’s the difference between inpatient and outpatient treatment?
Inpatient treatment programs are the most intense form of drug abuse treatment, providing around-the-clock care and requiring individuals to remain on-site for the duration of the program (typically 30, 60, or 90 days). Outpatient treatment is usually provided at night or in the early morning, allowing individuals to live at home and maintain their normal daily routines while they participate in a substance abuse program.
- National Institute on Drug Abuse. (2018). Behavioral Therapies.
- National Institute on Drug Abuse. (2018). Treatment Approaches for Drug Addiction.
- Substance Abuse and Mental Health Administration. (2016). Co-occurring Disorders.
- National Institute on Drug Abuse. (2018). Principles of Effective Treatment.
- Substance Abuse and Mental Health Services Administration. (2006). Detoxification and Substance Abuse Treatment: A Treatment Improvement Protocol, TIP 45.
- National Institute on Drug Abuse. (2018). Cognitive-Behavioral Therapy (Alcohol, Marijuana, Cocaine, Methamphetamine, Nicotine).
- National Institute on Drug Abuse. (2018). Contingency Management Interventions/Motivational Incentives (Alcohol, Stimulants, Opioids, Marijuana, Nicotine).
- National Institute on Drug Abuse. (2018). Community Reinforcement Approach Plus Vouchers (Alcohol, Cocaine, Opioids).
- National Institute on Drug Abuse. (2018). Motivational Enhancement Therapy (Alcohol, Marijuana, Nicotine).
- National Institute on Drug Abuse. (2018). The Matrix Model (Stimulants).
- National Institute on Drug Abuse. (2018). Family Behavior Therapy.
- Substance Abuse and Mental Health Services Administration. (2015). Medication and Counseling Treatment.
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