Treatment and Recovery

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 many people struggle with addiction for the rest of his/her lives but they still lead productive lives... if they continue to engage in the activies that helped them in the beginning of their recovery... Treatment questions may include: How many clients are clean six months after leaving the facility, one year, two years, five years? (Often people who relapse do not return to the same facility or admit they relapsed... most likely the person did not maintain a healthy lifestyle...might not be a reflection of the program but the person's commitment and environment), 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 was the program successful ?Bottom line this is a difficult question to answer. Was it the program or the person who makes it successful or unsuccessful?   

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.

• Anyone who has injected drugs or engaged in risky behavior should be tested for Hep C.
• The Importance of Exercise in Recovery
• Developing a personal/family plan (best if implemented in conjunction with professional help)

1. No single treatment is appropriate for all individuals. Matching treatment settings, interventions, and services to each patient's problems and needs is critical.
2. Treatment needs to be readily available. Treatment applicants can be lost if treatment is not immediately available or readily accessible.
3. Effective treatment attends to multiple needs of the individual, not just his or her drug use. Treatment must address the individual's drug use and associated medical, psychological, social, vocational, and legal problems.
4. Treatment needs to be flexible and to provide ongoing assessments of patient needs, which may change during the course of treatment.
5. Remaining in treatment for an adequate period of time is critical for treatment effectiveness. The time depends on an individual's needs. For most patients, the threshold of significant improvement is reached at about 3 months in treatment. Additional treatment can produce further progress. Programs should include strategies to prevent patients from leaving treatment prematurely.
6. Individual and/or group counseling and other behavioral therapies are critical components of effective treatment for addiction. In therapy, patients address motivation, build skills to resist drug use, replace drug-using activities with constructive and rewarding nondrug-using activities, and improve problem-solving abilities. Behavioral therapy also facilitates interpersonal relationships.
7. Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies. Methadone and levo-alpha-acetylmethadol (LAAM) help persons addicted to opiates stabilize their lives and reduce their drug use. Naltrexone is effective for some opiate addicts and some patients with co-occurring alcohol dependence. Nicotine patches or gum, or an oral medication, such as bupropion, can help persons addicted to nicotine.
8. Addicted or drug-abusing individuals with coexisting mental disorders should have both disorders treated in an integrated way. Because these disorders often occur in the same individual, patients presenting for one condition should be assessed and treated for the other.
9. Medical detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug use. Medical detoxification manages the acute physical symptoms of withdrawal. For some individuals it is a precursor to effective drug addiction treatment.
10. Treatment does not need to be voluntary to be effective. Sanctions or enticements in the family, employment setting, or criminal justice system can significantly increase treatment entry, retention, and success.
11. Possible drug use during treatment must be monitored continuously. Monitoring a patient's drug and alcohol use during treatment, such as through urinalysis, can help the patient withstand urges to use drugs. Such monitoring also can provide early evidence of drug use so that treatment can be adjusted.
12. Treatment programs should provide assessment for HIV/AIDS, hepatitis B and C, tuberculosis and other infectious diseases, and counseling to help patients modify or change behaviors that place them or others at risk of infection. Counseling can help patients avoid high-risk behavior and help people who are already infected manage their illness.
13. Recovery from drug addiction can be a long-term process and frequently requires multiple episodes of treatment. As with other chronic illnesses, relapses to drug use can occur during or after successful treatment episodes. Participation in self-help support programs during and following treatment often helps maintain abstinence.

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 most often 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.

SEE Support Groups     Recommendations:  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.”   

Free Naloxone in Florida   https://isavefl.com/find-naloxone.shtml