25 Jan Major Trends in Drug Rehab Treatment
Drug rehabilitation programs have changed a lot just in the past few years, and only for the better. For one thing, those who pay for the programs — insurance companies, parents, state governments, etc– are increasingly demanding evidence that a treatment really works before they agree to fund it. Therefore, there have been many more scientific studies of what works, so that drug rehab administrators are increasingly able to present “outcome-based evidence” that their programs are effective. This is just one of a dozen major new trends in the field of drug dependency recovery. Below are eleven more.
1. Drug rehab is a process not an event. The old thinking was that once a person withdraws physically from drugs, he becomes a “former drug addict.” The new thinking, again based on outcome-based studies, is that overcoming drug addiction, like obesity, requires long-term lifestyle changes in behaviors and attitudes, and sometimes even environments. The process can may take certain individuals years to complete, based on their personal histories of dependency.
2. Relapses are a predictable part of the drug rehab process. The old thinking was that if a person returned to drug use even once, he was back to the beginning of the process of recovery. The new thinking is that the majority of people relapse more than once and relapses do not take away the progress they have made toward achieving their goal of drug-free lives.
3. Drug rehab usually requires intensive treatment of thirty days or more, depending on the individual. The old thinking was that an addict did not need to enroll in a drug rehab program after withdrawing physically from drugs, but could stay abstinent only by attending support meetings. New research indicates, however, an addict is much more likely to recover if she enters and completes an intensive drug rehab program.
4. Intensive treatment means a residential program where you live at the drug rehab center for a month or more. Research shows that people who complete such programs are much more likely to be successful at permanent change, because they learn to live in drug-free environments and start over when they return home. The second kind of intensive treatment is attending all-day classes and counseling sessions for several weeks or months, often from 9 AM to 5PM, although you sleep at home.
5. A drug rehabilitation program has to be the beginning of deep lifestyle changes that a former addict must make in order to live without drugs. A person in recovery has to find new ways of coping with stress without using chemicals, and this can involve big steps such as changing careers, ending toxic relationships, setting new goals, and taking up stress relieving activities such as sports, fine arts, or meditation. Trained counselors can guide the person through these major changes.
6. Dual diagnosis is a new important trend in drug rehab today. Many people who become dependent on drugs have underlying psychological problems, which are usually not diagnosed until they enter drug rehab programs. Depression, eating disorders, attention deficit/hyperactivity disorder, bipolar disorder, and many other psychological problems have to be treated as separate issues from drug dependency in the drug rehab program.
7. Family involvement is necessary for a person to recover from drug addiction. The old thinking was you sent the person away “to get fixed.” The new thinking is that drug dependency occurs within complex systems of human groups at home, at work, at school, and among peers. To recover, you have often to change the person’s primary group’s dynamics.
8. Follow-up care is necessary after intensive treatment, and includes individual counseling, family and/or marital counseling, and attending support meetings such as Narcotics Anonymous. The old thinking was that a person could return to his old environment without formal support in place.
9. New medications are being discovered and approved all the time that are helping people more comfortably withdraw from drugs and remain abstinent.
10. People have more choices and diversity in selecting drug rehab programs. You can find programs that are individualized to specialized interests, such as ocean sports or fine arts, or in a geographical area you prefer. There are now specialty programs for gays, singles, Christians, women-only, men-only, and so forth.
11. Drug rehab programs are offering more payment options. Insurance companies are increasingly paying for longer stays, partly because of new legislation and government pressure. Administrators of programs are more willing to work with clients in terms of loans and payment plans. Private drug rehab programs that usually accept only private pay plans may work with you to get reimbursement from your insurance company.
American Journal of Psychiatry 2009;166:1269-1277. Randomized, double-blind, placebo-controlled trial of vigabatrin for the treatment of cocaine dependence in Mexican parolees.
Cognitive-Behavioral Therapy: An Overview. The National Institute of Drug Abuse, publication posted at http://www.drugabuse.gov/txmanuals/cbt/CBT3.html
Drug Treatment Outcome Studies (DATOS), see http://www.datos.org/adults/adults-intro.html
Kessler, Ronald. The epidemiology of dual diagnosis. Biological Psychiatry – 15 November 2004 (Vol. 56, Issue 10, Pages 730-737.
Ling, Walter, MD; Paul Casadonte, MD; George Bigelow, PhD; Kyle M. Kampman, MD; Ashwin Patkar, MD; Genie L. Bailey, MD; Richard N. Rosenthal, MD; Katherine L. Beebe, PhD. Buprenorphine Implants for Treatment of Opioid Dependence Journal of the American Medical Association 2010;304(14):1576-1583
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