When it comes to recovering from drug addiction, you’re bound to have a lot of questions about the healing process. How do you know if you need help? What kind of treatment is right for you? What can you expect from rehab? Our FAQ section offers answers to some of your most important questions about drug treatment.
There is no “wrong” time to seek help for drug abuse. Whether you’re in the early stages of addiction or you’ve been abusing drugs for years, you can benefit from the knowledge and support of compassionate substance abuse professionals. If you or someone you care about could answer yes to one or more of these questions, it could be the right time to seek treatment:
- You keep using drugs even though you’ve experienced health problems, relationship conflicts, job loss, academic failure, arrest, or a serious accident as a result of substance abuse.
- You need more drugs to get the effects you’re looking for.
- You have physical and/or psychological withdrawal symptoms when you try to quit, such as sweats, tremors, insomnia, nausea, muscle pain, anxiety, irritability, or depression.
- You’ve tried to quit more than once, but you relapse every time.
- Your drug abuse is making you feel scared, isolated, and out of control.
If you’ve considered seeking treatment for drug abuse, it’s important to know that you’re not alone. According to the National Survey on Drug Use and Health, nearly 24 million Americans over age 11 had used illegal drugs in the past 30 days before the survey. Over 22 million Americans met the criteria for a substance abuse disorder in the same year. The sooner you get the help you need, the sooner you can start creating the meaningful, rewarding life you want.
- What should I look for in a treatment center?
A treatment center should provide a safe, supportive environment where you can benefit from a full range of recovery services, including drug detox, individual counseling, group therapy, medication management, nutritional counseling, recreational therapy, and aftercare. Look for a credentialed facility that’s staffed by experienced, credentialed substance abuse treatment professionals and mental health therapists.
Before you’re admitted to a treatment center, you should have a full evaluation by professionals who will develop a specialized plan of care to meet your needs. From the admission process through detox, rehab, and discharge planning, your treatment center should provide support throughout your recovery. You should be introduced to a variety of treatment options, from residential care to partial hospitalization and outpatient services.
- What types of treatment are available?
There are several levels of care available for patients at different stages of addiction. Most programs begin with detoxification, a process that cleanses the drugs from your system and prepares you for the deeper work of recovery. Your treatment can take place at a residential (also known as “inpatient”) facility, where you receive 24-hour monitoring, or at an outpatient center, where you receive recovery services during the day while living off site. Partial hospitalization is an intermediate level of care, which is less intensive than residential treatment, yet more structured than outpatient rehab.
- What type of treatment is most appropriate?
The type of treatment that’s appropriate for you will depend on several important factors, including your history of drug use, your current level of drug intoxication, and your past experiences with treatment. The treatment team must also consider co-occurring health conditions — both physical and psychological — that could affect the outcomes of your treatment. Patients who show signs of mental illness as well as drug addiction require intensive, specialized treatment that addresses both conditions.
Matching the individual patient with the right level of care can be a complicated task. In general, patients with a more severe history of drug abuse and patients who are physically or psychologically fragile require a more intensive level of care, such as inpatient treatment or a partial hospitalization program. Those who are less advanced in their addiction and who are motivated enough to keep up with a more flexible program may be referred to outpatient treatment.
An intensive outpatient program can be just as appropriate as inpatient care in the right circumstances. A comparative study of patients in inpatient and outpatient treatment programs, published in Psychiatric Quarterly, found that inpatient treatment was typically more effective for patients with co-occurring psychiatric disorders and a lack of social support. Outpatient treatment was just as effective for patients who had a solid support network and no serious co-occurring disorders. This decision should be made only after careful assessment by an addiction treatment specialist.
- Will withdrawal be uncomfortable?
Drug withdrawal symptoms can range from mildly uncomfortable to life-threatening, depending on the type of drug, the extent of the drug abuse, and the user’s physical and psychological health. As the body and brain withdraw from the effects of drugs, you may experience side effects such as:
- Loss of sleep
- Loss of appetite
- Watery eyes
- Runny nose
- Muscle spasms
- Bone pain
- Involuntary movements
Drug withdrawal is usually accompanied by strong cravings for the drug of choice. These cravings can become so powerful that they overwhelm the user’s desire to quit. One of the primary goals of medical detoxification is to reduce withdrawal symptoms and cravings, so that the patient will be as comfortable as possible. Withdrawal can be made easier through medical monitoring, pharmaceutical therapy, fluid replacement, nutritional supplementation, and psychological support.
- Will withdrawal be dangerous?
Drug withdrawal is only dangerous if you attempt to withdraw by yourself without any medical support. It’s impossible for the user to predict all of the side effects of withdrawing from drugs, especially if he or she uses multiple drugs and/or alcohol. Side effects like seizures, fever, hallucination, and agitation can be life-threatening. The National Council on Alcoholism and Drug Dependence cautions that drug withdrawal symptoms should be managed by medical professionals who specialize in addiction treatment. Professional detox programs also increase the patient’s chances of success in recovery by providing the emotional support that he or she needs to take the next important steps to healing.
- How long does detox last?
During detox — the first stage in recovery — toxic chemicals are cleared from your system. The length of time required to complete this process can vary from one patient to another, depending on the extent of the user’s addiction. For lighter users, detox may last only a matter of days. The Treatment Episode Data Set report of 2006 indicated that the median length of stay in detoxification programs was four days, meaning that half of the users who were surveyed stayed longer, and half required more time to detox.
For heavy users, or those with complicated substance abuse histories, detox may take a week or more. Detoxification from certain prescription drugs, including sedatives or tranquilizers, may require a more extended drug tapering process to gradually ease the user off the medication and prevent serious side effects. Detox from narcotics like heroin, morphine, oxycodone, or hydrocodone often requires opioid replacement therapy with a drug like methadone or buprenorphine to ease withdrawal and curb cravings.
- What is dual diagnosis or co-occurring disorder treatment?
Co-occurring disorders (also known as a dual diagnosis) exist when an individual has a substance abuse problem combined with mental illness. In order to treat these patients successfully, a rehab center must provide treatment that addresses both the patient’s addiction and his or her psychiatric disorder. In a truly integrated rehab setting, mental health and substance abuse treatment services are provided at the same facility, by staff members who are cross-trained in both fields. Treatment plans are designed to accommodate the needs of patients who are struggling with both addiction and serious mental health conditions, such as depression, anxiety disorders, bipolar disorder, and schizophrenia.
Because the effects of drug abuse can often mask the symptoms of mental illness — and vice versa — identifying and treating co-occurring disorders can be challenging. To be effective, treatment must begin with a complete psychological assessment of the patient in order to determine the best course of recovery. In addition to substance abuse counseling, patients with co-occurring disorders usually require intensive psychotherapy, psychiatric medication management, and other services that are tailored to their mental health needs.
- How many people have mental health issues other than drug addiction that also need to be addressed?
Estimates on the prevalence of co-occurring disorders vary, but in general, statistics show that a large percentage of adults who abuse drugs also meet the criteria for one or more psychiatric disorders. The Journal of Addictive Disorders states that over 70 percent of individuals who abuse drugs or alcohol also meet the criteria for mental illness. The U.S. Department of Health and Human Services estimates that about 7 million American adults have co-occurring substance abuse and mental health disorders. Individuals with co-occurring disorders are more likely to suffer from serious problems like chronic unemployment, poverty, homelessness, physical illness, and incarceration.
- What is inpatient treatment?
Inpatient treatment, also known as residential treatment, takes place in a structured, supervised environment, such as a hospital, mental health facility, or dedicated rehab center. Inpatients receive intensive substance abuse treatment services — and psychiatric care, if appropriate — while living full-time at the facility. Inpatients receive 24-hour monitoring by doctors, nurses, or therapists in the security of a drug-free atmosphere.
Inpatient care is often recommended for patients who have a history of heavy drug use, for those who have serious co-occurring health concerns, or for those who have relapsed after previous experiences with treatment.
- What is outpatient treatment?
Outpatient treatment is a more flexible, less structured path to recovery. In outpatient treatment, the patient can participate in counseling, education, medication management, and other recovery services during the day while living at home or in a transitional living center. Detoxification services are also provided in outpatient settings. Outpatient programs are offered in many locations: rehab facilities, hospitals, community health centers, and correctional facilities, and more.
Outpatient services are appropriate for individuals who have graduated from inpatient treatment and who are ready to make the transition back to the community. This level of care may also be the right choice for those in the early stages of drug abuse who are still functioning effectively and who are highly motivated to quit.
- What is medical versus non-medical residential inpatient?
In medical residential treatment, patients receive pharmaceutical therapy and medication management from doctors, nurses, medical technicians, and other licensed personnel. Medications may be prescribed to ease the discomfort of withdrawal, to prevent drug cravings, and to help patients stay on track with their recovery goals. Patients with co-occurring disorders could also be evaluated and treated by medical professionals using pharmacotherapy as well as intensive counseling.
In non-medical residential or inpatient treatment, patients are monitored as they go through the withdrawal process and progress into rehab. However, the level of medical supervision is lower, and medication therapy is generally not provided as part of treatment. Non-medical drug treatment emphasizes behavioral modification, individual therapy, and group therapy instead of pharmaceutical interventions. Patients participating in non-medical treatment would typically be followed by physicians or therapists outside of the facility if psychiatric drugs or anti-addiction medications were recommended.
- What is the cost of treatment?
The cost of drug treatment varies considerably from one facility to another. Community health centers, non-profit or not-for-profit hospitals, and publicly funded rehab facilities provide recovery services at little or no cost. Forbes Magazine estimates that publicly funded drug treatment programs cost an average of approximately $1,500 at the low end, with the costlier specialized programs ranging up to $8,000 or more. Sliding scale payment plans and federal or state funding (such as Medicare) are accepted at these facilities. At the opposite end of the spectrum are private facilities that offer treatment at a much higher rate, ranging from $20,000 to $60,000 and higher. Some of these facilities accept health insurance as payment, while others accept only cash payment in full at the time of admission.
The services you receive will also affect the cost of treatment. Inpatient and residential programs typically cost more than outpatient services, due to the increased costs of staffing, housing, medical monitoring, and other expenses. Services like extra counseling, certain prescription medications, private accommodations, or optional therapies may come with an additional cost.
Regardless of your financial circumstances or your ability to pay, there is a level of drug treatment that fits your needs. Look for a facility that provides quality treatment from compassionate, highly credentialed professionals at a reasonable rate, with a variety of flexible payment options.
- Can I use insurance?
Not all drug treatment centers accept insurance, but many do. By the same token, not all health insurance plans will fully cover rehab services. Some plans cover only outpatient programs, which are usually less expensive than inpatient or residential care, while others will cover a wider range of options. Many insurance plans limit the amount of time that they will pay for treatment.
It’s important to discuss these questions with your insurance provider as well as the intake counselors at the center where you’re seeking admission. An intake counselor or case manager should be available to answer your questions and to find out whether your insurance company will authorize payment for the facility’s services.
- What are the success rates of treatment?
According to the National Institute on Drug Abuse, research indicates that most people who complete substance abuse treatment will reach their recovery goals, as long as they continue to take part in activities that support a drug-free lifestyle (sober activities, counseling, 12-step meetings, etc.) Statistics from the Substance Abuse and Mental Health Services Administration show that in 2006, nearly half (47 percent) of individuals who were admitted to drug or alcohol rehab completed their program. But success in long-term recovery isn’t just about graduating from rehab or staying drug-free for a certain number of days. It’s about creating a new life that supports the health of the body, mind, and spirit.
- Will travel be necessary?
Travel will be required if you choose to enroll in a treatment program outside of your community. For many individuals, traveling out of state gives them some distance from their usual drug abuse triggers and a new perspective on their lives. For others, leaving the community isn’t possible because of family relationships, job obligations, or legal issues. The decision about whether to travel to another state should be based on your individual situation and your personal requirements, as well as the specific services and the level of care that you need.
- How should I approach my loved one about going to treatment?
At one time, it was widely believed that only the addicted individual should make the decision to go to treatment. Today, however, substance abuse treatment specialists realize that intervention by family or friends is often necessary. If you’ve seen the signs of substance abuse in someone you care about, you may be hesitant to interfere, thinking that you’ll alienate your loved one or make the problem worse. In fact, stepping in to help someone you care about could literally save his or her life.
When you approach your loved one, try to be as calm and nonjudgmental as possible. Even if you have strong feelings and painful memories associated with your loved one’s drug abuse, it’s important to remember that addiction is now considered to be a chronic disease, similar to diabetes, heart disease, or cancer. In the early stages of drug addiction, an honest talk could be all it takes to persuade someone to go to rehab. However, most drug addicts develop a sense of denial about their problem as soon as they start using seriously. In most cases, by the time the problem becomes apparent, a one-on-one conversation isn’t enough to stop the damage.
The Mayo Clinic states that a formal intervention may be the most effective way to help someone who’s in denial about his problem, or who refuses to get treatment. An intervention is a planned meeting in which the friends, family, or coworkers of an addicted person meet with the individual in order to encourage him to get help.
- How do I conduct an intervention?
Interventions can be conducted in different ways. The structure and content of the meeting should be tailored to the individual’s situation. Some addicts can benefit from a firm approach, while others need a more gentle, encouraging tone. In general, the goals of an intervention are:
- To make your loved one aware of how her addiction is harming her life and the lives of those around her
- To discuss a plan for recovery, including a specific drug treatment program
- To present consequences if your loved one refuses to go to treatment, such as a marital separation or changes in a custody agreement
To maximize the effectiveness of an intervention, it’s best to hire a professional intervention specialist to help you plan and stage the meeting. Intervention specialists can help you outline your approach, choose the individuals who will be present at the meeting, and develop a proposal for treatment, or a treatment contract. An intervention specialist can coach you in effective communication techniques and prepare you for the various reactions you might face when you talk to your loved one. Although it’s possible to confront your loved one alone or with a small group, you’ll have the best chance of getting the outcome you want if you work with a professional from the beginning.
Treatment Statistics and Research
How effective is drug treatment — and are the people who need treatment really getting the help they need? A lot of research has been done by government agencies, academic institutions, and private organizations on the rates of success among Americans enrolled in substance abuse treatment. In addition, many drug treatment centers track the progress of their past and present clients. One of the most authoritative sources on treatment statistics in the US is the National Survey on Drug Use and Health (NSDUH), an annual nationwide survey that tracks trends in alcohol use, drug abuse, and mental health among Americans. According to the 2013 NSDUH:
- Nearly 25 million Americans over the age of 11 reported that they were currently using illicit drugs.
- Approximately 2.5 million Americans who needed treatment for drug or alcohol addiction got the specialized help they needed.
- Over 18 percent of Americans over age 17 had a form of mental illness.
- Over 10 percent of American teens struggled with depression.
- Over 3 percent of American adults had a form of mental illness combined with a substance abuse disorder.
What are the most commonly used drugs in the United States? In 2013, marijuana was by far the most widely abused drug in the US, with nearly 20 million Americans age 12 and older reporting use. Prescription drugs came in second, with close to 6.5 million Americans reporting nonmedical use of medications, and 4.5 million reporting the nonmedical use of prescription pain relievers, according to the NSDUH.
But with so many people reporting drug abuse, why are so few getting help? Denial is a big part of the problem. In 2013, fewer than 5 percent of individuals who described themselves as current drug users stated that they felt the need for help. Approximately 35 percent reported that they had tried to get into a drug treatment program, while over 65 percent reported that they had not even tried to get help. Out of those who wanted treatment but didn’t get it, most stated that they didn’t get help because they lacked financial resources or health insurance. Others stated that they weren’t ready to stop using drugs, or that treatment was inconvenient for them.
Barriers to Recovery
A study published in the Journal of Substance Abuse Treatment followed 312 adults who had just enrolled in substance abuse treatment to identify their barriers to recovery and their incentives for getting clean and sober. Misunderstandings and fears about drug treatment were common. Some of the most common obstacles to getting help included:
- Fear of discomfort or pain during treatment
- Concerns about confidentiality and privacy
- Memories of bad treatment experiences in the past
- Fear of being embarrassed or humiliated in treatment
Many of the participants were afraid to seek treatment because they were afraid that their families, friends, or employers would find out about their substance abuse problems. Some lacked knowledge of detox and rehab and were afraid of what would happen during treatment. However, motivating factors were also identified, such as the desire for better physical and mental health, the need for job stability, and the desire to build stronger relationships with loved ones.
For the addict, the prospect of getting treatment can be overwhelming. Even if you know that rehab will bring benefits like improved health, better relationships, a stronger self-image, and a more positive future, the idea of giving up drugs can be frightening. After all, drugs can be a source of temporary energy, emotional support, mental distraction, and pleasure. But according to the American Journal of Public Health, substance abuse treatment can decrease your risk of disease, injury, and premature death. The journal adds that early intervention and intensive treatment at the beginning of recovery can increase your chances of getting clean and staying that way.
Factors to Success
So what makes some people successful at long-term recovery? In a study of individuals seeking treatment for substance abuse, Drug and Alcohol Dependence identified several of the most important factors that contributed to their success:
- Developing a sense of self-confidence and competence
- Acquiring new coping skills to handle substance abuse triggers
- Access to recovery resources and support systems, such as 12-step groups
- Personal support from friends and family members
In other words, the stronger your inner resources and your social support network, the greater your chances of meeting your treatment goals will be. An effective drug treatment program can help you develop the inner strength and external support you need to build a healthy, rewarding life.