WHAT IS SUBSTANCE ABUSE?
Addiction to alcohol, drugs or both is also known as substance use disorders. They are complicated problems often compounded by mental and physical health conditions. Unfortunately, these disorders are often stigmatized in our society, and those afflicted are sometimes thought to have a character defect or moral weakness. This is unfortunate and untrue. However, physicians and medical scientists now consider addiction to be a long-term illness, like high blood pressure or diabetes. Most people who drink alcohol drink moderately, and many can stop ingesting drugs without difficulty. However, some people develop a substance use disorder which can be deadly.
Why Do Some People Develop a Problem but Others Don’t?
Addiction is a medical disorder that can affect anyone: rich or poor, male or female, employed or unemployed, and any race or ethnicity. Developing a substance use disorder depends partly on genetics— biological traits determine by family heritage. Environmental factors like socio-economic status and stress play major roles in contributing to the development of addiction. Researchers have found that drug and alcohol use cause fundamental changes in one’s brain chemistry in long-lasting and sometimes permanent ways. Early use of drugs or alcohol contributes to a greater risk of a person becoming addicted/dependent. These changes in the brain chemistry can remain long after a person stops using drugs or drinking alcohol.
What Are the Symptoms of Substance Use Disorders?
The most important and critical sign of addiction is continued use of drugs or alcohol despite experiencing serious, dangerous, and negative consequences of continued use. Denial of having a substance use disorder is very common and almost universal. Often an individual will find blame in other people or situations as the cause of their pain and suffering, and it often takes a cataclysmic shift for them to finally realize it is the substance their are using, often daily, that is the root cause of their troubles.
Other important symptoms of substance use disorders include
- Tolerance—A person will need increasingly larger amounts of alcohol or drugs to get high.
- Craving—A person will feel a strong need, desire, or urge to use alcohol or drugs, will use alcohol or a drug despite negative consequences, and will feel anxious and irritable if he or she can’t use them. Craving is a primary symptom of addiction.
- Loss of control—A person often will drink more alcohol or take more drugs than he or she meant to, or may use alcohol or drugs at a time or place he or she had not planned. A person also may try to reduce or stop drinking or using drugs many times, but may fail.
- Physical dependence or withdrawal symptoms—In some cases when alcohol or drug use is stopped, a person may experience withdrawal symptoms from a physical need for the substance. Withdrawal symptoms differ depending on the drug, but they may include nausea, sweating, shakiness, and extreme anxiety. The person may try to relieve these symptoms by taking either more of the same or a similar substance.
WHAT IS SUBSTANCE ABUSE TREATMENT?
- Who Provides Treatment?
Many different kinds of health care professionals provide treatment for substance use disorders. Often these individuals are specially trained, certified, and licensed substance abuse treatment providers. Many are in recovery themselves. Most treatment programs utilize a team approach, where patients are assigned to a medical doctor, mental health specialist and social services expert. This multispecialty team approach has shown to most affective in helping patients achieve sobriety.
What Will Happen First?
Upon entering treatment, patients receive a comprehensive clinical evaluation. A complete assessment helps guide the treatment professionals and enables them to formulate a customized treatment plan. Some individuals will need services from all the specialties while other may need just addiction treatment. Although clinical assessment continues throughout a person’s treatment, it starts at or just before a person’s admission to a treatment program.
Medically Supervised Withdrawal
Medically supervised withdrawal (detoxification) utilizes medication to help alleviate the physical and mental symptoms of withdraw from alcohol or drugs. For some individuals suffering from substance use disorder, medical supervision during withdrawal is mandatory when benzodiazepines or alcohol are involved. Withdrawal from certain substances can cause hallucinations, convulsions, or other dangerous conditions. Medication can help prevent or treat such conditions. Medically supervised withdrawal can occur in a hospital, inpatient detoxification unit, or on an outpatient basis. Detoxification generally occurs over days to weeks.
Many people can detox as an outpatient at home but some will require inpatient medically supervision. This decision is complex and requires experience. People with mild withdrawal symptoms from alcohol or drugs do not generally need to be hospitalized, and may that use drugs like cocaine, marijuana, opioids, or methamphetamine can successfully detox in the comfort of their own home or with family or friends. Alcohol and benzodiazepine addiction are the substances most highly associated with inpatient medical supervision. These are two substances that, in withdrawal, can cause severe illness and in certain circumstances death. Therefore it is best to be supervised and close to medical interventions when detoxing from these substances.
What Happens in Treatment Programs?
Most treatment programs are similar and include common elements.
- Assessment: All professional treatment programs begin with a clinical assessment. This assessment helps in the development of an effective treatment plan. Medical care typically includes screening and treatment for HIV/AIDS, hepatitis, tuberculosis, and women’s health issues. An individuals mental health is evaluated and a determination is made on weather the person requires additional services like psychiatric care or mental health counseling. A treatment plan is dynamic and changes as the persons needs change. It is written so that all treating specialists understand the goals of treatment and work in a concerted effort. The treatment plan helps both the professionals and the patient remain focused on the goals and objectives.
Relapse Prevention Training
Relapse is often part of a persons recovery story. Preparing for relapse and utilizing prevention techniques should be a part of everyone’s treatment plan. There are common triggers and circumstances to be aware of and activities and situations that should be avoided, these are just a few of the concepts incorporated into a relapse prevention plan.
Orientation to Self-Help Groups
Self help and the groups like Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are fundamental to many people who are on the road to recovery from addiction. Twelve-Step programs are perhaps the best known of the self-help groups and assist individuals in recognizing there own thinking errors, improving emotional well being, and communication with friends, family and co-workers.