An addiction treatment facility usually handles a wide range of addictions, although some facilities specialize in addictions to a particular type of drug. Addicts typically seek treatment only after a long period of addiction and often require coercion from an outside source. The specific programs used by an addiction treatment facility can vary greatly, and some facilities may use multiple programs.
An addiction treatment facility such as Delray Recovery Center often treats patients who are addicted to more than one drug. The types of drugs with a significant potential for addiction is very large, but the majority of them can be classified into a few basic categories. These categories include alcohol, benzodiazepines, opioids and stimulants.
The alcohol used for drinking is known chemically as ethanol and has other names such as ethyl alcohol and grain alcohol. It can easily be made with simple equipment by fermenting almost any liquid that contains simple sugar. Alcohol is a depressant of the central nervous system and is a very commonly abused drug. Modern medicine has considered alcoholism to be a disease since about 1960. Alcohol is one of the most commonly abused drugs, and the World Health Organization reported that about 140 million people in the world were addicted to alcohol during 2001. The cost of alcoholism in the United States was estimated to be 220 billion dollars in 2005.
The specific mechanism that causes a person to become an alcoholic are not well understood, although a variety of risk factors for alcoholism exist. These include age, environment, ethnic group, family history, gender, stress. Alcoholism is more common in men, although this proportion has begun to even out in recent years. Genetic factors account for 50 to 60 percent of the risk for alcoholism and environmental factors comprise the remaining 40 to 50 percent. Alcoholism typically develops during late adolescence or early adulthood. The long-term abuse of alcohol causes a variety of changes that result in the physical dependence and tolerance of alcohol. These changes maintain a person’s addiction to alcohol and cause withdrawal symptoms when the consumption of alcohol is discontinued.
Benzodiazepines are a large class of specific drugs. The defining characteristic of their chemical structure is a benzene ring and diazepine ring fused together. Leo Sternbach discovered the first benzodiazepine by accident in 1955, which is known chemically as chlordiazepoxide. This benzodiazepine was sold under the trade name Librium beginning in 1960. Diazepam is one of the most commonly known benzodiazepines, and has been sold as Valium since 1963.
Benzodiazepines increase the effect of gamma-amino butyric acid, which is a neurotransmitter. This action generally makes these drugs useful as sedatives, muscle relaxants and sleep aids. Physicians commonly prescribe benzodiazepines as a treatment for anxiety, convulsions, seizures and spasms. They may also be used to treat alcohol withdrawal symptoms. The duration of benzodiazepines can vary greatly such that the length of their effect determines their specific use. For example, short-acting benzodiazepines are used to treat insomnia while long-lasting drugs in this class are used to treat anxiety.
Benzodiazepines are generally safe and effective for short-term use, with cognitive impairments being the most significant side effect in therapeutic dosages. These effects include decreased alertness, drowsiness and a loss of concentration, which can be especially dangerous while driving. Dizziness and a loss of coordination can also increase the risk of traffic collisions and falling, especially among the elderly. Additional side effects of benzodiazepines include loss of libido and impotence. The long-term use of benzodiazepines is more controversial due to their potential for abuse and addiction. They can also produce severe withdrawal symptoms when their use is suddenly discontinued.
Natural opioids are a class of alkaloids that are found in the opium poppy. They are so-named because they come from opium, which is the dried latex that comes from the immature seed pods of the opium poppy. Natural opioids include approximately 30 specific chemicals, although only codeine, morphine and thebaine have a major pharmacological effect on the human nervous system. Synthetic opioids that are derived from these natural opioids include oxycodone, hydrocodone and hydromorphone.
The primary medical use of opioids is the treatment of acute pain, such as that experienced by patients after an operation. Physicians may also prescribe opioids to treat chronic pain, especially when it is caused by terminal conditions such as cancer. The use of opioids for non-terminal causes of chronic pain has grown significantly in recent years, which has led to an increase in the abuse and addiction to opioids.
The most common side effects for therapeutic dosages of opioids include constipation, drowsiness, dry mouth, itching and vomiting. Rare side effects of opioids include the following:
- Muscular rigidity
- Respiratory depression
- Urinary retention
Opioids can increase the amount of pain that patients experience in rare cases. This typically occurs when the dosage for a long-term patient is increased suddenly. The most common response to this effect is to rotate through multiple opioids, rather than administrating a large dose of a single opioid. The long-term use of opioids also compromises the immune system and it is likely to reduce testosterone production, especially in men.
An amphetamine is any drug that belongs to the phenethylamine class of drugs. They generally increase alertness and attention while decreasing appetite and fatigue. The most common brand names for amphetamines include Desoxyn, Dexedrine, Dextrostat, ProCentra, Adderall and Vyvanse.
The first commercial amphetamine was Benzedrine, which was introduced 1932. It was used to treat a variety of ailments including the common cold and asthma. Amphetamines were also used extensively during World War II to keep military personnel alert during long missions. Amphetamines were approved by the Food and Drug Administration in 1944 for the treatment of alcoholism, allergies and depression.
The commercial use of amphetamines increased dramatically during the 1950s, especially for the treatment of obesity. The use of amphetamines as a recreational drug also became popular during the 1960s due to the proliferation of illegal laboratories. The manufacture of amphetamines in the home became practical during the 1990s, and this remains a common method of obtaining amphetamines illegally.
The high potential for addiction has gradually reduced the approved medical uses for amphetamines. The only two medical uses of amphetamines currently approved by the FDA are attention-deficit hyperactivity disorder and morbid obesity. Amphetamines are also clinically effective for the treatment of narcolepsy, although this use does not have FDA approval.
The withdrawal symptoms of amphetamines can be severe and prolonged, which is the primary reason for the high relapse rate of this type of addiction. These symptoms typically include the following:
- Appetite increase
The motivation for seeking treatment for drug addiction can generally be categorized into financial, family and legal reasons. The financial incentives include the money spent directly on drugs and the lost productivity due to cognitive impairment. Drug addiction can also place stress on family members, who may coerce an addict into seeking treatment. A court may also order an addict to seek treatment in a facility such as the Delray Recovery Center.
Financial hardship plays a major role in the reasons that an addict may seek treatment for drug addiction. A successful treatment program can easily pay for itself when comparing the cost of such a program with the expense of drug addiction. These expenses include both direct and indirect costs.
Statistical data of the cost of addiction is difficult to obtain due to the illegal nature of these activities. However, addicts with a stable habit can easily calculate the direct cost of their individual addiction. For example, a modest heroin addiction can easily cost $30 per day. This is equal to a cost of about $200 per week, $800 per month and $10,000 per year. Cocaine is slightly cheaper than heroin, since it requires less processing. A dosage of amphetamines typically costs less than half that of heroin since the ingredients for making amphetamines are readily available.
An accurate calculation of the cost of drug addiction must also include the cost of lost productivity. Drug abuse typically results in greater absenteeism and an increased risk of losing one’s job. The cost of obtaining insurance is also dramatically higher for someone who abuses drugs. The average number of convictions for driving under the influence is 1.4 for someone with a drug problem, which can quadruple the cost of car insurance. The increased risk of illnesses and injuries can also increase the cost of health insurance.
Drug addiction can also cause additional financial difficulties. These can include late payment fees when the addict spends money on drugs instead paying off debt. This can also result in additional consequences in the form of reduced credit scores and higher interest rates. This can affect the cost of many purchases such as a car or house, and the loss of savings can have long-term effects on a college fund.
A drug addiction has a significant impact on the addict’s family, who may require the addict to enter a rehabilitation program as part of an intervention. Family costs created by drug addiction include the loss of property, due to when the addict must resort to theft to pay for drugs. A family may also need to pay for addition care-taking when an addict is unable to perform their household chores.
Drug addiction can also take an emotional toil on the family members of an addict. This includes the anger and resentment that family members feel when the addiction causes problems within the household. Family members may also experience shame and embarrassment when the addiction becomes public knowledge. A family with a drug addict must take precautionary actions against the addict’s behavior. This typically includes removing the addict’s name from family assets such as credit accounts and bank accounts.
A drug addiction also tends to reduce the quality of life for families. The addicted family member must spend time looking for drugs rather than spending time with the family. The time lost due to drug use also reduces the amount of time available to spend on the family, friends, learning new job skills and exercise.
Legal problems are also a common reason for entering a drug treatment program. Drugs such as heroin and cocaine are generally illegal to take under any circumstances. Many other drugs are legal to take with a prescription, but an addiction typically requires the user to commit a crime in order to obtain a sufficient quantity of the drug. This may involve forging prescriptions, doctor shopping and outright theft. In addition, drug-related behavior such as driving under the influence is generally illegal.
These crimes can carry stiff prison sentences, although first-time offenders may be sentenced to drug rehabilitation instead prison. Courts in the United States are increasingly more willing to explore alternative sentencing in cases involving drug use. However, this practice has also led to successful lawsuits on behalf of defendants who were sentenced to rehabilitation. These lawsuits generally have the greatest merit when the specific rehabilitation program has a religious basis such as Alcoholics Anonymous. Some courts have ruled that sentencing a defendant to this type of program violates the part of the First Amendment of the U. S. Constitution that deals with the separation of church and state.
An addict’s compulsion to use drugs can be very difficult to overcome without professional help. This often requires treatment at a rehabilitation center such as Delray Recovery Center, where the patient can be closely monitored. This is especially important during the detoxification phase to ensure the withdrawal symptoms do not become life threatening. A residential treatment facility is also helpful for restricting a patient’s access to drugs during the rehabilitation phase of the recovery process.
Treatment centers provide multiple programs for drug addiction. The basis of these programs is the 5-phase step-down model, which provides a comprehensive continuum of care. The first phase is the most restrictive and each successive phase provides the patient with more freedom. Individuals move through the phases at their own pace. Psychological counseling is also an essential part of formal rehabilitation. After-care includes the part of the patient’s recovery that occurs after being released from inpatient treatment. The specific treatment plan can also be customized to meet an individual’s needs, and may include a variety of recreational activities.
5 Phase Step Down Model
Detoxification is the first phase of the 5-phase step down model used by the Delray Recovery Center. This generally involves denying the patient access to the drug, which triggers withdrawal symptoms. The detoxification phase has a rigid structure and requires medical supervision. The most important purpose of this supervision is to prevent the patient from having seizures or falling into a coma. It typically lasts several days to a few weeks, depending on the drug and the severity of the addiction.
Partial hospitalization is the second phase of the 5-phase step down model. Patients may be admitted to this phase after detoxification once they are no longer a danger to themselves or others. Partial hospitalization is a level of care that provides close clinical treatment without continuous hospitalization. The primary goal of this phase is to customize the treatment plan for each individual patient. The duration of the partial hospitalization phase is two to three weeks, although it may be combined with the next phase of treatment.
The inpatient residential treatment phase generally consists of the patient living full-time at the facility. This phase may begin once the patient is satisfied with the customized treatment plan. A patient in the inpatient residential treatment phase works on the physical and psychological problems that result from the drug addiction. This phase typically lasts for at least three months.
The outpatient treatment phase requires the patient to live at home and home and return to the treatment facility at scheduled intervals for specific therapy sessions. These sessions primarily include psychological counseling, including individual and group therapy. Additional programs in outpatient treatment include life skills classes, art therapy, tai chi and outdoor excursions. Outpatient treatment normally lasts about 30 days.
The sober living phase has minimal structure, allowing the patient with the greatest amount of freedom to build on the foundation created by the previous phases. This phase deals primarily with the challenges of recovery as the patient integrates with the rest of society. Sober living is a highly customized phase, but it generally includes participation in group therapy sessions several times each week. The duration of this phase is highly variable and may continue as long as the patient wishes.
The original 12-step program was used to treat alcoholism and was published in 1939. This program has since been adapted for a wide variety of drug addictions and other forms of compulsive behavior. A 12-step program takes the view that individuals are powerless by themselves to control their addiction. This form of behavioral modification therapy requires participants to take specific steps to remain sober, such as admitting their addiction, renouncing their addictive lifestyle and seeking the support of a social network. A 12-step program also requires participants to believe in a higher power that can help them remain sober. This religious component is one of the greatest criticisms of 12-step programs.
Outcome studies for 12-step programs show that the one-year follow-up is an effective measure of success. This generally means that a patient who remains sober for one year after completing a 12-step program is likely to remain sober. A 12-step program is most effective in the treatment of alcoholism and least effective in the treatment of opioid addiction, which is typically treated with maintenance therapy.
Psychological therapy may also be part of a drug treatment program, especially for individuals with an underlying psychological motivation for their addiction. The specific therapy offered by treatment centers such as Delray Recovery Center may be categorized into traditional, alternative and holistic options. These sessions include 12-step sessions, life skills training and educational classes.
Existential therapy treats the patient’s life as a continuing change that provides the opportunity for improvement. This type of therapy allows the patient to develop self-awareness, responsibility and purpose. Gestalt therapy assists patients with integrating all aspects of their personality. This allows the patient to develop healthy coping mechanisms for their addiction. Narrative therapy takes the view that a patient’s past experiences affect his or her personality. This type of therapy uses the patient’s perception of these experiences to improve self-esteem.
Person-centered therapy explores healthy and fulfilling lifestyles that increase self-awareness. Psychoanalytic theory uses the patient’s childhood to determine the influences on his or her current personality. Reality objectification seeks to provide patients with an objective viewpoint of the external world. The goal of this type of therapy is to develop healthy methods of dealing with situations beyond the patient’s control. Rational Emotive Behavior Therapy focuses on identifying irrational thought processes. The patient can then replace these thoughts with healthier ways of thinking.
Relapse therapy deals specifically with identifying the cause is of a patient’s relapse. This type of therapy primarily takes the form of REBT, in which the therapist discovers the relapse triggers so that they may be managed or eliminated, usually through the development of new coping skills and behavioral modification. Relapse therapy must also address the feelings of guilt and shame that a patient feels after a relapse.
A successful treatment plan for drug addiction requires a combination of good facilities and treatment specialists. These specialists must have professional training in addition to a sensitive, caring attitude. It is also important that they not be critical or judgmental of their patients.
Success is difficult to measure in a drug treatment program because drug treatment experts disagree widely on what “success” is. Treatment centers also do not publish their records in many cases to protect the privacy of their patients. The relapse rate of a treatment program is one measure of success, but this can be misleading since drug addicts often relapse after the end of their formal treatment.
Many drug treatment experts measure success by the ability of a program to provide its patients with the tools needed to lead a drug-free life. This measure of success means longer treatment programs are considered more successful. The trend in drug treatment programs is currently towards longer treatment periods. These programs have a historical length of 30 days, whereas 90 days is now considered the standard period for a drug treatment program.