Alcoholism and Drug Rehab FAQs
- What does 'best practices' mean?
- What makes a quality drug rehab?
- What are the components of a comprehensive drug addiction treatment program?
- What are the differences in detox programs?
- Why do I have to go to treatment if I have successfully completed detox?
- What is an individualized treatment plan?
- What is the difference between individual and group therapy?
- What is a multidisciplinary team approach to addiction treatment?
- Why do some people go to long-term treatment?
- Why do people leave treatment early?
- How does treatment impact health issues such as HIV/AIDS or Hepatitis C?
- What are specialty treatments?
- I am a Christian and want a Christian treatment program. What should I look for?
- Do all treatment programs address sexual orientation?
- Why do people go to residential treatment away from home rather than outpatient treatment near home?
- Why should I go out of state for treatment?
- Are services provided for family members at drug treatment facilities?
- If I have gone through treatment before, does it make sense to go again?
- Why are there separate programs for adolescents and adults?
- Is there a difference between addiction treatment for men and women?
- What is holistic addiction treatment?
- How can I save my job and take time to go to treatment?
- Does an addict have to enter treatment voluntarily for it to be effective?
- What is an intervention?
- What is an addictionologist?
- What is the difference between a licensed therapist and a certified addiction specialist?
- Are there pros and cons to being placed on methadone?
- What is the Joint Commission?
- What are Federal and State HIPAA laws?
- How long does residential addiction treatment last?
- How successful are addiction treatment programs?
- Does everyone in an addiction treatment program receive the same treatment?
- What is a dual diagnosis program?
- Do all addiction treatment programs offer medically supervised detoxification?
- What is the cost of addiction treatment and what payment options do rehabs offer?
- Are visitors allowed at addiction treatment facility?
- What do I need to bring to rehab?
- What is a family program?
- Can I bring my cell phone and computer?
- Can I receive phone calls?
- Can you smoke cigarettes in addiction rehab?
- Can I just go to detox?
- What type of licensing and accreditation should a treatment program have?
- How important is it to have a medically based treatment program?
- Are aftercare plans individualized?
Decades of research studies have found that certain approaches to addiction treatment and aftercare work better than others. These approaches are known as 'best practices' and are used by quality treatment programs.
A comprehensive, medically based drug rehab of quality uses:
- Best practices
- Certified addiction physicians and other medical professionals
- Therapists with advanced degrees
- A multi-disciplinary team approach
- A variety of therapeutic modalitiesÂ
- 12-Step program principles
All of these components can provide a newly recovering addict with the best opportunity to build a strong foundation for living life clean and sober. A quality drug rehab seeks to provide the patient with the best care possible.
Based upon several decades of scientific research, comprehensive drug rehab programs should at minimum include the following:
- Individualized treatment plans
- Individual and group therapy
- Regular evaluations
- Addiction workshops
- Relapse prevention
- Mental health disorder workshops (if needed)
- Medication management (if needed)
- Aftercare plans
- Life skills training
There are more component parts or modalities in treatment that can be offered depending upon the quality of the rehab center.
There are several different types of detox programs.
- Outpatient detox: A patient goes to a clinic and self-reports on progress through detox, progress in treatment, and on drugs taken. The clinic may dispense medication to be taken at home relying again upon self-reporting as to the efficacy of the drugs.
- Hospital detox unit: A hospital may have a specific unit in which people will come to detox.
- Detox facility: A separate facility which houses only detox units. These facilities are usually medically based and staffed but offer no addiction treatment.
- Detox unit within a drug or alcohol rehab facility: A quality comprehensive rehab center should have a separate medically monitored detox unit on the premises that operates as the first phase of the drug or alcohol rehab facility's substance abuse treatment program. Whether from alcohol detox or drug detox, the alcohol or drug rehab center provides the addict with a seamless transition from detox to addiction treatment.
There is a serious misconception among both addicts and family members that detox is alcohol or drug treatment. It is not. The purpose of detox is to rid the body of the drug or alcohol's toxins. It is a complex process that can be life threatening depending on a person's age, amount of substance used, how long use has occurred, physical health, and emotional and psychological health. Detox does not address the underlying reasons for substance abuse or the mental health problems that may accompany substance abuse. Addiction treatment is the next phase in the recovery process, but it can only occur after one's body has been cleansed of drugs and alcohol in detox. Successful long-term recovery can only be achieved through addiction treatment, it cannot be achieved by undergoing detox alone.
An addict entering a drug or alcohol rehab program should receive an individualized treatment plan created for the particular patient. The patient's needs for treatment must be based upon the individual's health condition, substances used, mental health disorders, emotional and psychiatric health, and a host of psychosocial issues. Not all alcohol and drug rehabilitation centers offer individualized treatment plans despite evidence that it is considered to be a best practice.
When someone enters a quality drug or alcohol rehab program, he or she should receive a variety of different therapeutic modalities in addiction treatment to help him or her learn about self-destructive behaviors and coping skills.
In individual therapy, the patient works one-on-one with a therapist trained in addiction and mental health issues.
Group therapy is also a vital aspect of treatment. It involves a carefully comprised group of addicts who meet together with a trained therapist to work through personal issues. The group dynamic can be empowering as one learns that his or her issues are not unique while simultaneously receiving support and challenges from peers.
The best approach to treating addicts is to use a variety of scientific approaches. This means that a certified addiction physician, a psychiatric nurse, a psychiatrist with expertise in addiction and mental health issues, and other therapists and clinicians can pool their knowledge and experience together on a team. This team approach can create a comprehensive individualized treatment plan for each patient based upon the input of a variety of disciplines.
For a variety of reasons, a person may not have the capacity to go through a short-term treatment program and remain abstinent from drug or alcohol use in his or her daily life. There can be emotional problems, environmental problems, physical problems or a combination of problems that make recovery harder to maintain. In these cases, after several tries at treatment, a patient may need to go to a long-term treatment program to achieve the best results. These programs can be 3 to 24 months in duration.
It takes a good deal of work, commitment and serious desire to go through treatment. Sometimes, an addict is challenged to look inward and take responsibility for what he or she has done with his or her life. The addict must be willing to do this self-reflective work in order to build the foundation for recovery. An unwillingness to self-reflect may lead a person to leave treatment early. Also, if a patient suffers from an undiagnosed mental health disorder, the emotional turmoil can lead the person to leave treatment. Finally, if a person decides to seek outpatient treatment instead of inpatient treatment, or the patient goes to an inpatient treatment program near home, family and friends can disrupt the patient's focus. These different issues can cause a patient to leave treatment before the program has been completed.
When a person is living in active addiction, he or she may engage in risky behaviors. The end result of risky behaviors can be acquisition of infectious diseases or other serious health conditions. In a quality treatment facility with a full-time medical staff, these conditions can be addressed and successfully managed.
Everyone who enters a drug or alcohol rehab program comes to rehab with a unique story. While everyone is unique, certain similarities remain constant. These similarities generally combine into demographics such as adolescent drug and alcohol users, senior drug abusers, members of the LGBT community, those seeking treatment through the filter of religion such as Christian treatment, or those suffering from mental health disorders. These groups require specific components of treatment to address certain demographic needs. Counselors are trained in the unique needs of each specific demographic in specialty treatment.
A quality Christian treatment program will combine best practices and medically based treatment modalities of addiction treatment with clinicians who are Christian. The addiction education component of Christian addiction treatment should specially include treatment workbooks that incorporate Christian principles and use a recovery bible as part of the treatment protocol. However, addiction treatment that relies only upon religious works without addressing the mental health issues and the physical realities created by drugs and alcohol cannot provide a Christian patient with the tools needed to live a clean, sober and healthy life. Addiction is a disease of the mind, body and spirit that requires a broad, medically based approach to recovery as well as a healthy spiritual base.Â Here is a guide to Choosing a Quality Christian Based Treatment Program for more detailed information.
No, all treatment programs do not address sexual orientation or other specific demographic needs. It is imperative that an addict finds a treatment program that philosophically believes in treating the individual and that will address the individual's needs in a formal manner based upon personal self acceptance. Our guide to choosing an LBGT friendly drug rehab can assist you with your decision.
Why do people go to residential treatment away from home rather than outpatient treatment near home?
Outpatient treatment is best used as an aftercare approach to recovery once an inpatient or residential treatment program has been completed. Residential treatment or inpatient drug or alcohol rehab centers away from one's home allow the addict time to focus solely upon himself or herself.
In quality residential treatment, the therapists, physicians and other healthcare professionals can observe the patient's behaviors and emotional status, providing an accurate and current evaluation of the patient's progress with the ability to respond to emergencies as they arise.
There are many distractions or feelings of obligation to family or friends that can stop a patient from staying in treatment. If a patient goes out of state for treatment, communication between the patient, family and friends is limited and the possibility of leaving treatment to go home is less likely. Treatment takes effort, focus, and emotional space. Missing one's children, for example, can cause a person who is close to home to leave rehab before treatment is completed. It is best to put distance between oneself and everything else to build a strong foundation for long-term recovery.
Not all rehab facilities provide family members with therapy. Since the 1960s, scientific studies have demonstrated that addiction is a family disease. To change the environment at an addict's home, everyone in the home must be treated for addiction. Issues of personal responsibility, consequences and codependent behaviors need to be addressed and tools need to be provided so that the family dynamic can move from dysfunctional to healthy.
There is always hope for anyone suffering from alcohol and drug addiction. Treatment will work if you are willing to face your addiction with complete honesty, personal responsibility, and willingness to make the changes necessary to grow. Scientific studies have demonstrated time and again that treatment works if the patient uses the tools provided in treatment and aftercare to achieve lasting sobriety.
Adolescents are still growing physically, emotionally and intellectually. The problems that confront an adolescent are different from those of an adult. It is for the safety of the adolescent that the groups are not placed together in any way during treatment. Adolescent treatment protocols are different than those for adults because the asolescent brain is still developing. Changes in the brain from drugs and alcohol affect adolescents differently than adults. In order to create a safe environment in which he or she can heal, the adolescent needs to find identification and support among his or her peers in treatment. Identification allows adolescents to see their self-destructive behaviors. To accomplish this self reflection, the adolescent needs to be physically separated from adults.
There can be differences between addiction treatment for women and men. Women do not tend to resort to denial as much as men do, but they tend to suffer from more guilt and shame. Confrontational approaches that work better with male patients generally do not work well with female patients. Issues concerning rape, incest, domestic violence, body image and sexual abuse are often best dealt with in single-sex groups. Vulnerability around these issues is profound for both men and women and issues such as being re-victimized in a therapeutic setting has led to separate protocols for men and women in some cases.
Quality holistic addiction treatment programs are based upon the concept that the whole person must be treated. While many of these programs employ natural remedies such as yoga, massage, meditation and natural diets, quality holistic addiction treatment will also provide the patient with formalized addiction treatment protocols and, when needed, medical assistance.
If you have worked for a company for 12 months and meet other criteria, the Family and Medical Leave Act (FMLA) provides you with the opportunity to take an unpaid leave of absence to enter treatment. You will need to find out the rules governing the FMLA and your company's requirements. Validation of your medical leave needs will be required. The treatment facility should be able to assist with the paperwork. It should also be noted that use of the FMLA can protect your privacy so that where you are and why you are there is protected.
Treatment can be effective even if an addict enters treatment through the threat of jail, the loss of a job or the loss of family. Once in treatment, the addict must be open to learning, listening and being honest. What happens during treatment is not dependent upon how one gets into treatment.
An intervention is an action that interferes with a behavior with the single purpose of changing that behavior. With regards to addiction, an intervention is the confrontation of one person by others to address his or her addiction with the goal of moving the addict into treatment. Years ago, interventions were aggressive and confrontational. That approach has proven to be detrimental to the desired goal. Today, there are several types of interventions, including professional and nonprofessional interventions. Depending on the circumstances, the people involved and the temperament of the addict, the style of the intervention needed can differ. For more information, refer to this guide to Planning an Intervention.
An addictionologist is a certified expert healthcare professional, usually a physician, trained to identify and treat addiction. The American Board of Addiction Medicine and the American Society of Addiction Medicine provide physicians with the opportunity to be board certified. The designation of board certification or the certification from ASAM is evidence of expertise.
Both a certified addiction specialist and a therapist are licensed. However, a licensed therapist may not have any expertise or experience with addiction, addiction medicine or addiction treatment. Addiction treatment requires special training. There are different levels of certification such as a CAS (certified addiction specialist), CAC (certified addiction counselor), CAP (certified addiction professional) and board certified. Each different certification is determined by the level of education and training in addiction, treatment and recovery. The highest level is a board certified addictionologist, which is a physician with a specialty in addiction medicine.Â Here is more on Substance Abuse Counselors.
There was a time when methadone was seen as the only alternative for someone addicted to heroin. Many people do well on methadone, but it is a powerful drug whose use must be carefully monitored. In recent times and with the development of a variety of drugs, people no longer have to go on methadone maintenance to stop using heroin. A variety of new classes of drugs such as Subutex, Suboxone, and naltrexone can help an addict stop using opiates without having to substitute one addiction (heroin) with another (methadone).
The Joint Commission is an independent, not-for-profit organization that certifies healthcare organizations and programs across the United States. The Joint Commission is dedicated to improving healthcare for the public through its accreditation and certification process. The Joint Commission helps to set healthcare industry standards.
HIPAA laws were developed to protect the privacy of patients. With the advent of electronic recordkeeping, HIPAA laws were developed to secure patient confidentiality, integrity and availability of patient information. The laws set specific rules and limits about who can gain access to patient information and what can or cannot be done with that information.
Drug and alcohol addiction treatment is very important to the long-term recovery of an addict. In general, the longer one can stay in residential treatment, the better the outcome. Many treatment programs are based upon insurance guidelines and the length of a treatment stay may be based upon insurance approval. Generally, residential treatment can range from a few days to 28 days especially if it based solely upon insurance allowances. However, in quality addiction rehabs, based upon a medical model, the treating physicians can speak to the insurance company and help extend the patient’s stay by several weeks.
Long term residential treatment is exclusively for those with several disorders and a history of unsuccessful treatment attempts that require extended treatment for a minimum of 3 months to a year.
Studies indicate that addiction treatment increases the chances of maintaining sobriety for longer periods of time. The success rate is dependent upon the gender, the drug of choice, the age, and finally the type of treatment received. Medically based treatment programs that combine 12 Step programs tend to have greater success rates than other types of treatment.
If you are seeking treatment for alcohol or drug abuse, or a dual diagnosis, you want to make sure to choose a treatment program that has a medical based, best practices, program. Such treatment programs will provide patients with individualized treatment plans. Not all facilities are medically based, nor do they have multidisciplinary teams of certified addiction physicians, nurses, psychiatrists, therapist and other clinicians.
When an individual has a mental health disorder such as depression, anxiety, panic disorder, or suffers from a drug or alcohol addiction, the person is considered to be dually diagnosed. Accurate diagnosis of the mental health disorder is of the utmost importance, as both the addiction and the mental health disorder must be treated simultaneously. Recovery is less likely if only one condition is treated. A quality treatment program will have a credible dual diagnosis program staffed by addiction physicians, nurses and therapists who have expertise and experience with dual diagnosis treatment.
No. All treatment facilities are not able to offer a medically supervised detox unit. A medically monitored detox requires medical personnel as well as an onsite pharmacy. Special licenses must be obtained to incorporate the pharmacy and the detox within the treatment facility.
There are many different types of addiction rehabs. Some treatment programs are run by the local, state or federal government. These treatment facilities are free of charge but have waiting lists. There are also privately owned addiction rehab facilities. The cost varies for each treatment program and depends upon the services offered, the quality of the program (award winning, research based, medically supervised), the quality of the staff (certified addiction physicians, nurses, psychiatrists, Master’s level therapist, nutritionists, etc) and finally, the ratio between patient and therapists. Some programs also have private pay options (the patient can use his or her resources to supplement treatment not covered by insurance).
Treatment is an all encompassing process. To help maintain focus, patient safety and stability at a vulnerable time in life, visitations must be approved in advance by the treating therapist. Only significant family members or close friends will be given permission to visit a patient. Generally visitations will occur at specific times during weekends.
Laundry facilities are on site necessitating only a small amount of clothes. There is limited space and little storage available so a few loose fitting pants, shirts, and shorts, enough clothes for 7 days are all that is needed. Pajamas and personal hygiene items such as a toothbrush and a shaver are also needed. Short shorts, tank tops, shirts cut at the mid section and other provocative clothes are not allowed, nor are clothes with pictures of drug paraphernalia, drug expressions, or inappropriate language (sexist, racists for example). Specific treatment programs will have a list of items that are allowed and disallowed. The rules must be followed. Inappropriate clothing for treatment will be confiscated and held until the patient is ready to leave. All confiscated items will be returned.
Not all addiction rehabs offer a family program but keep in mind that addiction is considered a family disease. Addiction alters everyone’s life. To address that reality, a quality addiction treatment program should have a formal family program. A quality family program is designed to explore the unhealthy dynamics within the family structure, issues of codependency, abuse, power struggles and other addictions that poison the family unit. Issues of resentment, anger, fear and control need to be addressed early in recovery. Everyone in the family must learn about addiction and how to respond to the disease for themselves and for the person in treatment.
The benefit of treatment away from home is the ability to limit communication with and distractions from the outside world. The absence of cell phones and other electronics provides patients with safety from dealers, bill collectors, friends and other potential distractions. Recovery from addiction takes effort and focus. Cell phones serve no positive value in the treatment environment.
Phone calls are generally limited to family members or close friends who are your within your support system. Because your time is limited in treatment, focus and concentration are necessary to achieve sobriety and work on difficult personal issues. Treatment programs have specific days and times during which phone calls may be made by patients to significant people. Family members may call in to speak with administration or a nurse about their loved one’s progress and to leave the patient a message. Messages left by family members are given to patients. The goal is not to shut off communication with family and close friends, but to limit the time patients are on the phone and distracted from the work of recovery.
Not all drug or alcohol rehabs allow smoking. However, if it is permissible to smoke cigarettes at a facility, smoking can occur only in designated areas during breaks between groups and during free time. You cannot leave group to smoke a cigarette during any scheduled sessions.
Free standing detox facilities do exist and you can choose to go to a detox facility without going to treatment after. However, detox is different than treatment. Detox is the process through which the body is cleansed of toxins created by drugs and alcohol. That is it. A detox facility will not provide you with individual counseling, addiction education, relapse prevention, dual diagnosis education, medication management, strategies to handle cravings or any of the components found in a treatment program. Studies have demonstrated that for the majority of people detox alone will not help you stay clean and sober.
For a treatment facility to legitimately operate it should have state and local licenses. That would be the minimum. The Joint Commission is an independent, non-profit organization that accredits and certifies health care organizations across the nation. Health care providers move through an extensive review of the facility grounds, structure of the organization, delivery of services, quality of staff, program philosophy as well as a providers ability to provide services across the continuum of care ensuring that the highest, safest, best quality of care is offered to all who seek help.
Treatment programs have progressed over the last three decades. A medically based treatment program should be able to provide you with ongoing onsite evaluations conducted by a multidisciplinary team of doctors, nurses and therapists trained in addiction medicine.
Things to ask:
- Does the treatment facility have medical staff on site during regular business hours with additional on-call coverage 24 hours a day?
- Is the medical team, doctors and nurses, employees of the rehab?
- Does the treatment program follow the latest medical best practices, and research based protocols?
- Are there individualized treatment plans created and are they updated regularly by the team?