Treatment: Where To Start
What is Addiction?
Addiction is a complex brain disease that is manifested by compulsive substance use despite harmful consequence. People with addiction have an intense focus on using a certain substances, such as alcohol or drugs.
What is Substance Use disorder?
Substance use disorders occur when the regular use of drugs or alcohol impair one’s physical health, mental health, and/or ability to function in daily responsibilities at school, work, or home.
Risk Factors for Addiction and Substance Use Disorder:
- Family history
- Having a mental illness
- Peer pressure
- Loneliness or social isolation
- Lack of family involvement
- Drug availability
- Socioeconomic status
Symptoms of Addiction and Substance Use Disorder
- Impaired control: a craving or strong urge to use the substance; desire or failed attempts to cut down or control substance use
- Social problems: substance use causes failure to complete major tasks at work, school or home; social, work or leisure activities are given up or cut back because of substance use
- Risky use: substance is used in risky settings; continued use despite known problems
- Drug effects such as tolerance and withdrawal symptoms
Most people experience both mental illness and addiction. The mental illness may be present before the addiction, or the addiction may trigger or make a mental disorder worse.
What does treatment look like?
Treatment for addiction and substance use disorder looks different for everyone. It can take place in different places, for different periods of time. Treatment will be individualized based on each person’s specific situation, and it will address an individual’s physical, psychological, emotional health. Therapy can help individuals understand their behavior and motivations, develop higher self-esteem, cope with stress and address other mental illness.
What are my treatment options?
(Low to Medium Intensity): Clients typically attend no more than nine hours of treatment a week (slightly less for teens) at a specialty facility while continuing to live at home. Many programs make services available in the evenings and on weekends so individuals can remain in school or continue to work.
(Medium to High Intensity): Clients attend 10-20 hours of treatment a week (slightly less for teens) at a specialty facility while continuing to live at home. Many programs make services available in the evenings and on weekends so individuals can continue to work or stay in school. A better option for individuals who need multiple services, have accompanying medical or psychological illnesses, or have not been successful in outpatient treatment.
DAY TREATMENT / PARTIAL HOSPITALIZATION
(Medium to High Intensity): Clients attends four to eight hours of treatment a day while continuing to live at home. This is beneficial when the individual needs an intensive and structured experience. Day treatment can be appropriate for individuals with co-occurring mental illness.
(Medium to High Intensity): These programs provide treatment in residential settings and can last from one month to a year. Residents usually go through different phases as they progress through the program.
(High Intensity): Treatment provided in specialty units of hospitals or medical clinics offering both detox and rehabilitation services. Typically used for people with serious medical conditions or mental illness.
For individuals with an addiction to opioids, medication is provided as a treatment in a specialized outpatient setting in combination with counseling and other treatment services.
There are various medications used to treat opioid addiction including buprenorphine, methadone, and naltrexone. These medications can be administered in a treatment facility or physician’s office or prescribed to take at home. With MAT, individuals can go through Detoxification Treatment (30 – 180 days) or Maintenance Treatment (for years). Medications are typically combined with counseling for a holistic approach to treat opioid addiction. Medication coupled with social services is the most effective treatment.
MAT increases social functioning and retention to behavioral therapy. It has been shown to decrease opioid use, overdose deaths due to opioids, and infectious disease transmission. It also improves outcomes of newborn babies born from opioid-dependent women. As mentioned before, everyone’s path to recovery is different. Talk with qualified physicians and providers to discuss your options and whether or not a specific medication is best suited for you.
Methadone can relive cravings for narcotics, suppress the withdrawal symptoms, and block the euphoric effects associated with heroin when taken regularly. It is a long-acting agonist that can suppress withdrawal for up to 24 -36 hours. By law, methadone is a schedule II drug that can only be dispensed through an Opioid Treatment Program. Office-based clinics are not allowed to dispense methadone for treatment.
Buprenorphine is a scheduled III drug that can be prescribed in physician offices to take home. Much like methadone, it has pharmacological properties that can suppress the effects of withdrawal symptoms and cravings, and can lower the potential for misuse. It’s more commonly used name is Suboxone, which is a mixture of naloxone and buprenorphine.
Naltrexone, also known as Vivitrol or Revia, works differently from buprenorphine and methadone. It is able to block the effects from opioids, like heroin, morphine, and codeine, which prevents the feeling of getting high. Before starting naltrexone, patients must abstain from illegal opioids and opioid medication for a minimum of 7 – 10 days.
Am I eligible for MAT methadone/buprenorphine treatment?
To be eligible for MAT methadone/buprenorphine treatment, federal regulation requires documentation of 1 year of opioid-related addiction history. Documentation can include: Substance abuse treatment, hospitalization, inpatient detoxification, a report from your primary care provider, criminal records, or notarized statement from a family or clergy member.
You may also be able to receive MAT methadone/buprenorphine treatment if you…
- Want the detoxification treatment, which is a gradual taper for 30 -180 days
- Have been recently released from prison ( not jail ) within the past 6 months
- Are pregnant
- Have been previously treated before for up to 2 years after discharge