The dust has begun to settle ever so slightly on the Affordable Care Act (ACA), known popularly as Obamacare, giving us a glimpse at what might be and what has already begun to change in terms of helping some of the most vulnerable among us – people struggling with addictions and mental illness.
As someone who works directly with this population, I am optimistic. It’s still early in the process, but the ACA’s mandated health coverage is having important practical and philosophical effects. In practical terms, more people are getting on the insurance rolls; philosophically, there’s increased recognition that those dealing with mental health issues or substance abuse need and deserve help, and that it benefits all of us when they get it.
Drug rehab centers put a number of guidelines in place to ensure the safety of their patients, many of which are challenged by recovering addicts looking for as much normalcy and comfort as possible during the difficult early stages of recovery. One of the most frequently asked questions is: Why no Adderall to treat my ADHD during treatment?
When you’re searching for a drug rehab, one of the first recommendations you’ll hear is to find a program that is accredited. What does it mean for a program to be accredited? And does accreditation ensure quality treatment?
In lieu of or in addition to getting licensed by the state, some addiction treatment programs choose to get accredited by a third party. In the U.S., drug rehab centers are most commonly accredited by:
It is an unfortunate reality that most doctors don’t like treating addiction, and they don’t like addicts. They’ll treat the consequences of the disease but they won’t always confront the underlying issues, discuss treatment options or provide referrals to an addiction specialist or even a self-help support group like AA. What’s behind this institutional bias against addicts?
A Health Care System in Denial
Denial keeps addicts stuck in their disease. It’s also keeping our health care system sick. An estimated six million addicts receive health care in hospitals, emergency rooms and primary care clinics each year. This kind of access puts doctors in an ideal position to recognize and treat addiction, yet they receive very little training on how to do so. During medical school, there’s no required course in addiction and only a few states require continuing education in the use of narcotic medications and the management of chronic pain.
During drug rehab, dozens of different therapies may be incorporated into a treatment plan. If you’ve done your research and chosen a reputable rehab center, it’s best to keep an open mind and trust the advice of your treatment team. But there are a few instances when you may want to do your own research, get a second opinion or even decline a certain treatment:
#1 The Treatment Isn’t Backed by Research
Thanks to a growing body of research, we have a good idea of what works and what doesn’t in the treatment of addiction. Even with this knowledge, a surprising number of treatment centers use interventions that are not backed by research. In fact, a five-year study by the National Center on Addiction and Substance Abuse (CASA) at Columbia University found that most people receiving treatment for addiction “do not receive anything that approximates evidence-based care.”
Psychosocial therapies, medication, nutrition and exercise, and self-help support groups are a few examples of effective components of a comprehensive treatment plan. Newer therapies that haven’t been around long enough to be thoroughly studied also may be worth trying, especially if they have very little potential to do harm.
Do-it-yourself detox programs make lofty promises, assuring addicts they can get clean ultra-fast, ultra-cheap. While easy fixes are difficult to resist, especially when it comes to a challenge as great as addiction, anyone who promises a painless, quick and permanent transition from addict to non-addict is deluded about the nature of this disease.
Detox, the process of eliminating drugs and alcohol from the body, is the first step toward recovery. For all our disagreements, one of the areas in which addiction specialists are nearly unanimous is that drug detox should take place in a licensed detox facility where the process is monitored and supervised by medical professionals.
Based on media portrayals and folklore, we’re led to believe that people and wolves are arch enemies that compete for food and resources. Science has a different story to tell – one not only of coexistence but even cooperation.
Today, wild spaces are dwindling and wolf populations have been slow to rebound from near extinction, but people continue to benefit from interactions with these smart, sensitive creatures. For most of us, our beloved dogs – direct descendants of wolves – are the closest we’ll ever get to a wolf. Wolf Connection, an innovative wolf therapy program and wolfdog rescue in the high desert north of Los Angeles, seeks to change that.
When the wolfdog rescue first opened in 2009, founder Teo Alfero sought to educate and empower young people by simply allowing them to spend time with the animals. Four years later, it has evolved into a therapeutic program with a set of “wolf principles,” or lessons humans can learn from wolves. Wolf Connection now serves a number of specialized populations, ranging from abused and neglected foster care children and juvenile delinquents to veterans with post-traumatic stress disorder and people struggling with drug addiction.
There is little evidence that depression or suicide rates rise during the holidays, but the season is certainly known for its excesses. Although just as many people (if not more) need help for drug and alcohol addiction, fewer people reach out for treatment in the last couple months of the year. Addicts generally object to being away from home during family gatherings at Thanksgiving or Christmas, but for some families, seeking help during the holidays could be the greatest gift you give this year. Here are a few ironies that keep addicts sick over the holidays:
Even in the face of serious consequences, some addicts put off getting help so that they can get through the holiday festivities without disappearing off to rehab. Some party even harder around the holidays, flying under the radar of loved ones because it is socially acceptable to overdo the celebrating. Unfortunately, the stress of the season can exacerbate substance abuse, leaving an addict spiraling out of control.
The day before Thanksgiving, described in the media as Black Wednesday, is one of the biggest partying nights of the year, with the National Health Institute estimating that 10.8 million underage drinkers binge that day. According to Nielsen reports, alcohol consumption increases dramatically in December and in the week leading up to the New Year. All of this alcohol fuels as much as a 25 percent increase in alcohol-related traffic incidents, prompting President Barack Obama to declare December National Impaired Driving Prevention Month.
When people arrive at an addiction treatment center, they typically don’t want to be there. They’re agitated and apprehensive, and they doubt whether they even have a problem, especially one that is as bad as their families, employers or the courts believe.
In many cases, the last thing they want to do is sit down for talk therapy or attend a support meeting, though both are essential elements of treatment. What they do want is relief from the discomfort of withdrawal.
There is no better way to begin building rapport with a client – and to keep them in treatment – than to listen attentively and help them feel better as quickly as possible. This is where complementary and alternative therapies can be of great value to the addict, particularly in the early stages of recovery.
Whether a client agrees with the therapist’s perspective or not, they are appreciative of any intervention that addresses their insomnia, anxiety, muscle cramps and other withdrawal symptoms. Not only are these symptoms unpleasant, but they are also major factors in relapse.
Once the therapist shows an interest in the problem as the addict defines it, the addict is more willing to talk about the problem as the therapist defines it. And so a relationship begins.
Last month, The National Center on Addiction and Substance Abuse (CASA) at Columbia University released a five-year study assessing the state of addiction treatment in the U.S. Among other findings, CASA reported that only one in 10 people in need of addiction treatment get it, and of those who do, most “do not receive anything that approximates evidence-based care.”
Evidence-based care does exist in a minority of treatment centers, but how does one go about finding it? What exactly is evidence-based care? In short, evidence-based care is treatment that is backed by scientific research. According to CASA, it includes the following elements:
Comprehensive Assessments – To understand each individual’s specific needs, CASA advises physicians and other health professionals to complete a comprehensive assessment. This assessment should evaluate the individual’s medical, psychological, social, family and substance use history, current health status, addictive behaviors, personality traits, and the presence of any co-occurring disorders.
Based on this assessment, the team develops an individualized treatment plan that contains specific goals and interventions. As the patient’s needs change, the treatment plan is revised accordingly.