Recovery

IF you are concerned that a person has an addiction to any drug please take him/her to a doctor with experience/knowledge about addiction and other mental health issues

MY PERSONAL RECOMMENDATIONS: Essential components in a recovery program whether residential, outpatient, or at-home should include:  intense/formal follow-up programs, highly structured program, family counseling sessions and spirituality components.  

Four Essential elements of programs that offer the best rate of success should include:

1. A highly structured program with a daily activities schedule - meetings and often assigned job tasks at the facility or partnerships with local shops/companies

2. A formal transition program - i.e., residential to intense outpatient then tapering down to less intense outpatient program. Residential may not be necessary nor feasible. Look for intense outpatient programs. Some facilities offer structured evening programs- the key is to have a day full of structured activities particularly the first several months of recovery. Having a good relapse prevention program or recovery enhancement program will help a person with their transition back into the “real life” and allows a person to gradually utilize their newly acquired skills and strategies into their personal environment. Is there an alumni program?

3. FAMILY program - if the family is not involved in the recovery process, they certainly will be a part of the relapse process! The family or close friends need to educate themselves (be on the same page as the person in recovery) on the complexity of addiction and recovery.

4. Spirituality in program- Recovery involves the mind, body and spirit. Spirituality help a person find a purpose in life and renew a sense of hope. Spirituality has a personal meaning for every individual but most importantly it will offer a person a since of hope and meaning.  Spirituality is “an inner sense of something greater than oneself. Recognition of a meaning to existence that transcends one's immediate circumstances.”  Spirituality is distinct from religion. The AA/NA programs works on developing the spiritual side to life and a successful recovery. In my opinion, it is moving from the self-centered life of an addict to a compassionate, self-giving life of a caring, person working on recovering.

Other key elements:

  •  Exercise- A KEY to recovery especially for opiate addicts. If a full exercise program is too difficult begin with walking daily adding some distance weekly, eventually toning muscles and exercising the heart & lungs with a cardiac workout. Exercise improves sleep.
  • Eating Habits- In the beginning it is not uncommon for a person to crave sweets. Drugs often become more important than eating hence the person may have lost their appetite for food.
  • Sleep- Developing good sleeping habits is essential in recovery.   

*Be sure to have your child/adult child sign a consent form for any doctor, councilor, or program you all choose for help. This is consent for you to ask a few questions and work with the professional not for the doctor to divulge personal, private information

The first question on your mind may be “What is a facilities rate of success?” Facilities often seem vague when attempting to answer this question or may state something outrageous such as 99%. The reality is that many people struggle with addiction for the rest of his/her lives but they still lead productive lives... most of the time. Recovery questions may include: How many clients are clean six months after leaving the facility, one year, two years, five years?, How many clients are returning clients?, What is the follow-up program after a client completes residential treatment or out-patient treatment?...If a person is in residential treatment for a year then relapses a few weeks after “completing” the program and leaving the facility. Was this a successful program?

The reality is that it is possible for people who have struggled with addiction to lead productive drug-free lives; however this may be more difficult for some people than others and may require multiple relapses.  Due to the complexity of the disease determining who will succeed, what type of program is best and when a person will triumph over this disease is frustrating impossible to predict.

As you may have gathered abstinence from one’s substance of choice is really only the first step to a success recovery. The body , mind and soul have to change from artificial substances controlling their lives to living in the real world, making good decisions and beginning to enjoy life drug-free.

The goal with any program should be to help the person develop good, new skills that become good, new habits that continue after the official program is completed.  Without continuing these habits and further developing these skills relapse is more than likely inevitable.

  • Participate in good support groups, AA or similar to get support with maintaining a drug-free life, other support groups such as church, sports clubs, book clubs… your interest…
  • Eat well, establish good sleeping habits & exercise
  • Develop a spiritual life to maintain hope and guidance at all times
  • Stay busy; establish a structured life
  • Formally serve others when the time is right
  • When the time is right do something you have always wanted to do… study a new language, new hobby, join a local sports team, join a book club……

Please don’t think the more you pay the better the facility or that it insures a better recovery. Be open and do your research

 


Interview facilities to better understand their philosophy and policies.

1. What type of accreditation or licensing does the program have?
National accreditation programs (such as the Joint Commission on Accreditation of Health Organizations, the Rehabilitation Accreditation Commission, the National Committee for Quality Assurance, and the All-States) look for elements of treatment that research has shown to be effective. Accreditors also require a well-documented patient complaint process. Remember that "state licensing" is not the same as accreditation, since states vary widely in their licensing requirements. Failure to obtain accreditation may mean nothing but it could indicate fringe status or, in the worst case, a quasi-cult or an abusive form of "care."

2. Have there been studies to measure the effectiveness of the program's treatment methods?
Treatment effectiveness is a new field of study, so it is too early to expect all providers to have full research-based evaluations of their methods. Still, it is not too early for them to be planning these studies. The most objective evaluations usually come from external agencies rather than "in-house" evaluators.

3. What medications does the program support or prescribe to treat an addicted patient's other possible medical problems? Is its staff knowledgeable about and willing to consider the use of medication that may help treat addiction?
Many of addicted patients' medical symptoms may be complications of addiction, and clear up after a period of sobriety, but this is not always the case. Clinical depression, anxiety, or conditions can undermine chances for recovery. The best treatment programs evaluate patients for such problems shortly after admission and offer appropriate medical care, including medication if indicated. Also, medications such as methadone, naltrexone, and disulfiram (Antabuse), can be effective in helping some addicts. Treatment centers should discuss them with patients.

4. What sort of "aftercare" does the program offer?
Short-term treatment by itself is not enough to sustain recovery in most patients. Aftercare is crucial, preferably at least a year of weekly or biweekly outpatient counseling, plus participation in Twelve-Step programs (such as Alcoholics Anonymous) or other addiction self-help groups (such as Rational Recovery or Women for Sobriety). A good treatment program will actively help the patient integrate into a self-help group, although patients sometimes have to "shop around" to find the one in which they feel most comfortable.

5. What does the program do about relapse?
Unfortunately, relapse is a common occurrence in substance abuse treatment “just as it is in treatment for other chronic illnesses. A good program includes relapse prevention classes that teach patients to recognize and avoid or deal with situations and emotional states that could trigger relapse. It should also have a plan for the patient's reentering treatment and/or support groups to prevent a one-time lapse from becoming a full-blown return to active addiction. Relapse “though demoralizing“ can be an important learning experience; but the individual may need further help.

6. Does the program accept your insurance? If not, will they work with you on a payment plan or find other means of support for you?

7. Is the facility clean, organized and well-run?

8. Does the program encompass the full range of needs of the individual (medical: including infectious diseases; psychological: including co-occurring mental illness; social; vocational; legal; etc.)?

9. Does the treatment program also address sexual orientation and physical disabilities as well as provide age, gender, and culturally appropriate treatment services?

10. Is there ongoing assessment of an individual's treatment plan to ensure it meets changing needs?

11. Does the program employ strategies to engage and keep individuals in longer-term treatment, increasing the likelihood of success?

12. Does the program offer counseling (individual or group) and other behavioral therapies to enhance the individual's ability to function in the family/community?

13. Are services or referrals offered to family members to ensure they understand addiction and the recovery process to help them support the recovering individual?

Other questions to consider:
What is the assessment procedure for dual diagnosis?
What if a person in the program wants to leave?
What kind of mental health professionals do they have?  psychiatrists? other physicians?
      -If a patient gets sick, who assesses the patient? other mental health professionals?
Number of patients a therapist, psychologist or counselor has?
How often do the professional involved see a patient?
Is there a program manager?

Typically- psychiatrist administer medication and discuss with a patient if the medication is working and how the patient is adjusting to the medication vs. a psychologist using his/her skills and knowledge of addiction helps the client learn to make good, healthy rational choices and decision to help the client remain drug-free and lead a productive and fully functional life.

 

Teresa Miller
tmiller@stoprxdrugabuse.org
 

 

Recovery: The term recovery has a complex meaning and is often misunderstood by the people not involved in the addiction field. What is recovery? - Betty Ford Institute.

THERE IS A DIFFERENCE BETWEEN ABSTINENCE AND RECOVERY. Abstinence is the first step in recovery from drug abuse or addiction.. Then address the physical and psychological damages the body and mind have undergone. At a minimum begin attending support group meetings (Alcoholic Anonymous)  or other similar support groups while looking for a good counselor or psychologist that will work with the family. It is extremely beneficial to seek the help of a profession to begin retraining the brain to function without the use of artificial stimulation. Physically the person most likely has neglected food and exercise and would rather drink or use than do anything else. The lack have food and exercise may have made the body and mind weak. When a person first stops using he/she may suffering from withdrawal symptoms (often flu-like symptoms) and may not want to eat. Strongly encourage them to eat well-balanced meals. Begin walking everyday then gradually begin to increase exercising. A person may crave sugar products/drinks while in the beginning stages of recovery  (Back to Questions)
Detox is not treatment; it’s the first phase of getting stable so a person can connect to the right level of care.
Medical Detoxification is a process whereby individuals are systematically withdrawn from addicting drugs in an inpatient or outpatient setting, typically under the care of a physician. Detoxification is sometimes called a distinct treatment modality but is more appropriately considered a precursor of treatment, because it is designed to treat the acute physiological effects of stopping drug use. Medications are available for detoxification from opiates, nicotine, benzodiazepines, alcohol, barbiturates, and other sedatives. In some cases, particularly for the last three types of drugs, detoxification may be a medical necessity, and untreated withdrawal may be medically dangerous or even fatal.
Detoxification is a precursor of treatment.
Detox Facility: Take the person to an emergency room if you can’t find a facility or have any reason to believe the situation is life threatening... particularly if drugs and/or alcohol have been mixed... don’t hesitate to take the person to an emergency room     Search the internet for local detox centers.
  (Back to Questions)

(Back to Questions)

How to pick out a facility: Drug and Alcohol Services Information System (DASIS)- Fact Sheets, Statistics, Facility locator...
Do your research...
1. Have an independent doctor, psychiatrist or counselor do an assessment to make recommendations for treatment and to determine physical & mental health.
 2. If resident or outpatient treatment is best call various treatment centers for the best fit. (You should get recommendations from the experts you consult.) For example, some programs offer only outpatient services, some follow the 12-step program theory, ... 
    See list of questions to ask when calling recovery facilities
3. If outpatient counseling is the treatment similar questions (see above) can be asked. The counselor should emphasize balance in lifestyle to include a spiritual element to instill hope.
4. Begin random drug testing. 
5. Begin to study the disease of addiction...educate yourself. The more you learn the better you will understand what is essential on the road to recovery.  link to literature

Because denial is often a characteristic of addiction, many people who are addicted to or who abuse drugs won't seek medical treatment on their own. Family members, friends or co-workers may need to persuade the user to undergo screening for drug addiction. Breaking a drug addiction may involve counseling, an outpatient treatment program or residential treatment.  Mayo clinic

It is important to remember that many opiate addicts relapse after their first detox/recovery attempt.  Coping skills- Mayo clinic

Statistically the recovery rate for those people who attend programs voluntarily vs. those people who are forced into recovery are the same. Most people suffering with an addiction are not capable of making good decisions (if he/she were able to make a healthy & rational decision surely he/she would decide to stop using and seek help).

Don’t confuse cost of a program with the quality of a program. The more you pay doesn’t equate to a superior program. Some of the best programs are run by non-profit organizations particularly those run by churches. Often 30-day programs are a little more than a glorified detox. If you think you need to go to a residential program and can only afford it for 30-days then look for a program that has a good outpatient (follow-up) program. It make take 2-3 years to relearn how to make healthy, rational decisions and to build confidence in your new lifestyle.

Follow-up Care is Crucial to a Successful Recovery Program  (Back to Questions)

 

Expectations of treatment: Chart is from the article linked below.
“What can we expect from substance abuse treatment?”  Dept of Health and Human Service 

 (Back to Questions)

Why do I need to seek professional help?
A prof
essional therapist, psychologist, counselor, psychiatrist or medical doctor offers a client the skills, academic knowledge, experience , access to valid tools of each profession, knowledge of additional references and objectivity that a family member or friend cannot provide.

Individual therapy: Psychologist/counselor/therapist- Try to interview the therapist to determine if it is a good fit. . Even if the person does not want to get help remind him/her the need: to develop good, positive decisions making skills, to learn what their personal triggers are and how to avoid them and thus avoid relapsing, and how to set new realistic goals. I would recommend a behavior/cognitive therapist. Their focus is on changing behaviors and reprogramming how the mind thinks. It is often most helpful to see a therapist weekly for 3 months. A more intense program of twice a week for the first two months may be necessary and would help toward building a good, trusting relationship. The real question to ask is, “Do you want to be struggling with these same problems year after year?
Psychiatrist- Suboxone may be a good additional to therapeutic treatment. I thought the hospital would prescribe suboxone for at least a few days to make transitioning home easier but it wasn’t prescribed. Find a doctor who prescribed this medication. Taking suboxone truly helps a person stay focused on recovery and healing without the physical and mental distraction of craving the drug . During the second month my son forgot to take his medicine and said it felt like a machine gun was going off in his brain telling him to use. Pretty powerful statement.
Out-patient therapy: Utilizing a program that offers group therapy and random testing may also be an additional useful tool for recovery.

If you are seeking a recovery facility utilize google, read reviews, and call and ask questions. Remember the expensive programs typically does not equate to more successful or better programs.

Completing a treatment program does not equate to being recovered. Participating in treatment is the first step in the recovery process. Recovery is the process of making permanent healthy lifestyle change.  (Back to Questions)

12-Step Support Groups- Encouraging the attendance of 12-step programs can be good, supplemental support for both recovery addicts and recovering families. I have read over a dozen books, all recommend attending meeting and getting involved with a sponsor. “90 meetings in 90 days.” If you can’t afford professional therapy at least utilize the support offered from 12-step programs. I am truly convinced that this program works for people who are willing to work it. Remember relapsing isn’t failing it is often part of recovering.

  • Alcoholics Anonymous /Narcotics Anonymous (for the person in recovery) and Al-Anon/Nar-Anon (for families) meetings. 
    BEST WAY to find meetings is to google "aa meeting in tampa"  a local website should be at the top of the list.  For Tampa:  
    http://www.aatampa-area.org/meetings.html
  • Parents, spouse, or close friends may want to attend Ala-Teen for siblings or children of someone struggling with addiction) meetings for support. These meetings are extremely helpful for building a support group. You may feel like your other friends or family members just don’t understand or worse they may blame you for the addict’s behavior or make you feel guilty about something you can’t change.

The Role of Social Supports, Spirituality, Religiousness, Life Meaning, and affiliation with 12-Step programs in Quality of Life... NIH public access- click on PDF for printable download

12-step programs and other support groups are wonderful for building a finding hope and building new friendships. But don’t confuse support groups with group therapy. Group therapy is a form of therapy that will allow an individual learn strategies for avoiding triggers that may lead to relapse, learn how to socialize in a healthy & safe environment, provides an atmosphere for healing. Both programs are excellent for aiding in recovery but support groups should not be a substitute for group therapy or individual therapy.
Support Group Link
Group therapy and support groups have different purposes.

Personal Note:  Choosing between an AA and a NA meeting or Al-Anon and Nar-Anon is a personal choice all follow the twelve step philosophy of recovery.  Depending on where you live and the availability of meetings you and/or your family may want to attend a few different meetings to determine which one bests fits your personal needs. Getting involved and committed may prove to be more beneficial in your recovery process. 
Why should a person with an addiction avoid all mind- altering chemicals (alcohol, drugs, even limiting caffeine and sugar)?  
“Cross-addiction going from one drug to another, i.e. alcohol to marijuana, heroin to cocaine, etc., etc.  the underlying reason is that the addict’s body chemistry is addictive, therefore, hyper-sensitive to all addictive substances, even if the effects of the substance are different.  Thus the brain remains in addictive mode, even if the original drug is not taken.”   (Back to Questions)

Helpful links for additional recovery information:
Partners for Recovery- SAMHSA
Addiction Treatments Present and Past
Locate psychiatrist treatment for Suboxone (Buprenorphine) 
Mayo Clinic: Adult Health
Additional Info:
            National Alcohol & Drug Addiction..U.S. Dept. of Health
            Involuntary Treatment    Voluntary Treatment - Florida
                  Google your State to see if it offers any programs
 Addiction Journal- Parent’s blogging about their own person experience.   An excellent nightly radio show for everyone- free downloads RECOVERY COAST TO COAST

YouTube- Stories of Hope and Recovery

 

ental health evaluation and possible detoxification.

Common Withdrawal Symptoms Produced by Various Drugs

 

 

Marijuana

Nicotine

Alcohol

Cocaine

Opiates (morphine and heroin)

Irritability

X

X

X

 

X

Low Mood, Depression

 

X

 

X

X

Anxiety

 

X

 

 

X

Sleep Disturbance

X

X

X

X

X

Nausea

X

 

X

 

X

Cramps

X

 

 

 

X

Increased or Decreased Heart Rate

 

X

X

X

 

Craving

 

X

X

X

X

Source: O'Brien CP. 1996. Drug addiction and drug abuse. In: Harmon JG, LimbirdLE, Molinoff PB, Ruddon RW, Gilman AG, Editors Goodman and Gilman's The Pharmacological Basis of Therapeutics. 9th Edition. New York: McGraw-Hill. Pp. 557-577.  http://www.nap.edu/read/9586/chapter/4#52