Archives for May, 2012
As a result of numerous outcome studies conducted in the past decade, there is a growing consensus that for those who can manage it, long-term addiction treatment is the most effective option. We frequently meet the addict who bounces from 30-day rehab to 30-day rehab, only to hold onto their sobriety after staying in treatment for many months. Thirty days of residential treatment used to be the generally accepted standard in treatment. Why 30? Not because research showed its effectiveness, but because that was the average length of stay covered by insurance. Now, the National Institute of Drug Abuse has declared 90 days of treatment the “gold standard.” This is because research shows that people completing at least 90 days of treatment have significantly lower relapse rates than those who stay for shorter amounts of time.
Why Longer Is BetterIt’s difficult for people to commit to 30 days away from their families and jobs, not to mention 90-plus days, but addiction is a chronic, relapsing disease that takes time and ongoing effort to address. Longer treatment stays offer the following benefits: • Detox Doesn’t Dominate. Depending on the individual and their drug history, detox may take up a significant portion of a 30-day drug rehab program. And while detox is a critical part of the process, it is not in itself treatment. With a longer treatment stay, clients still have several weeks or more following detox to engage in the deeper work of recovery.
In just about any self-help support group meeting around the world, you will find people who have been through unimaginable pain standing tall and fearlessly sharing their stories. Despite devastating personal losses, lifelong health problems and broken relationships, they are not consumed with shame. In fact, many seem strangely at peace with their past. This is the freedom of recovery without regret. Because addicts tell lies and make repeated mistakes, regret commonly becomes an obstacle to recovery. Left to fester, regrets not only make it difficult to learn from the past and move forward but they can also take valuable time and attention away from recovery, increasing the risk of relapse. Though painful, regret can be an important part of the healing process. In treatment, we see regret as a sign of readiness to change. As addicts become increasingly aware of the negative consequences of their drug use, regret is a natural response. In its healthiest form, regret drives the addict to ask, “What can I do differently right now to right the wrongs of the past and make better decisions in the future?”
Women don’t want to admit it. Their families often turn a blind eye. Yet drug and alcohol addictions that were once considered a man’s problem now affect an estimated 2.7 million women. Women have different reasons than men for using drugs and tend to become addicted faster and after using smaller amounts of drugs than their male counterparts. They also have different reasons for relapsing. Here are the top five challenges that pose a threat to women in recovery:
#1 Getting into Romantic Relationships Too SoonRomantic relationships in the early stages are one of the most significant threats to recovery. If (or more likely, when) they go awry, the loss can send recovering addicts into an emotional spiral. Until their new coping mechanisms are securely in place, it is not unusual for relapse to follow every time a relationship goes wrong.
It is the sign of a healthy society when government faces its mistakes and develops more effective policies. This is a process we see unfolding as the U.S. government reconsiders its drug policy and sets forth a “new national approach” that focuses on treatment rather than punishment. In April, the Obama Administration released its 2012 National Drug Control Strategy, which builds on the President’s inaugural National Drug Control Strategy, published in 2010. The strategy is grounded in three research-based premises that are now widely accepted in the treatment field: • Drug addiction is not a moral failing, but a preventable and treatable chronic brain disease. • People can and do recover from addiction. • Criminal justice reforms are needed to stop the cycle of drug use, crime, incarceration and rearrest.
We often read about how to tell if we're addicted to prescription painkillers and what to do if we are addicted. But what about the early signs – signs that could indicate the need to take action before we become dependent? Few people wake up one morning suddenly addicted to prescription opiates. The process is typically more gradual, which means there are numerous opportunities for early intervention. Here are the earliest signs that your use of pain medication is beginning to cross the line into addiction: #1 You’re starting to use your pain medication to feel better, not just to ease pain. Most people who use prescription opiates have pain as a result of an accident, surgery, illness or other condition, and then take their medicine to relieve that pain. Those who become addicted have pain, take the medicine and find that they not only have less pain but they also feel better in other ways. Perhaps it helps you sleep, energizes you, makes you feel more confident, or relieves stress or anxiety. When you take the medication, you may find that it numbs emotional pain, allows you to escape from difficult thoughts or feelings, or gives you a sense of pleasure. A shift occurs where you’re no longer taking the medication because you’re in physical pain but because of the positive effects on your mood or outlook. You’re now taking the drug to get high.
Long before I began working in residential addiction treatment programs, I spent much of my career in hospitals and community-based treatment settings. In working with disadvantaged populations in community treatment programs, it became clear to me that only limited improvement can be achieved with medication alone. There are many changes in people’s brains and behaviors that must take place for them to lead fulfilling lives. Despite a growing body of neuroscientific research, we have yet to develop effective new treatments for addiction. Addiction is indeed a biological disease, but it is also a behavioral and spiritual one. As a result, modern medicine’s focus on developing new medications to treat addiction has fallen short. Fortunately, some researchers are beginning to explore behavioral mechanisms that may fill in some of the gaps in addiction treatment. In a study published this month in Science, researchers from the National Institute of Drug Dependence at Peking University used a behavioral procedure to manipulate addicts’ memories of past drug-taking that shows promise in reducing drug cravings and preventing relapse.